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Abstract This study compared weight and cardiometabolic changes after short-term treatment of olanzapine/samidorphan and olanzapine. Eligible criteria for an included trial were ≤ 24 weeks, randomized controlled trials (RCTs) that compared olanzapine/samidorphan and olanzapine treatments in patients/healthy volunteers and reported weight or cardiometabolic outcomes. Three databases were searched on October 31, 2020. Primary outcomes included weight changes and all-cause dropout rates. Standardized mean differences (SMDs) and risk ratios (RRs) were computed and pooled using a random-effect model. This meta-analysis included four RCTs (n = 1195). The heterogeneous data revealed that weight changes were not significantly different between olanzapine/samidorphan and olanzapine groups (4 RCTs, SDM = − 0.19, 95% CI − 0.45 to 0.07, I 2 = 75%). The whole-sample, pooled RR of all-cause dropout rates (4 RCTs, RR = 1.02, 95% CI 0.84 to 1.23, I 2 = 0%) was not significant different between olanzapine/samidorphan and olanzapine groups. A lower percentage of males and a lower initial body mass index were associated with the greater effect of samidorphan in preventing olanzapine-induced weight gain. Current evidence is insufficient to support the use of samidorphan to prevent olanzapine-induced weight gain and olanzapine-induced cardiometabolic abnormalities. Samidorphan is well accepted by olanzapine-treated patients.

Abstract We compared the efficacy, safety, and acceptability of lurasidone at different doses to establish the dose–response relationships of lurasidone therapeutic and adverse effects in acute schizophrenia. Included trials were 4- to 16-week, fixed-dose, randomized controlled trials of lurasidone in adults with acute schizophrenia. Different doses of lurasidone, other antipsychotics, and placebo were considered as independent treatments. Apart from all-cause dropout rates, four therapeutic and four adverse outcomes were included in the frequentist network meta-analysis (NMA). Lurasidone 160, 120, 80, 40, and 20 mg/day were studied in ten trials of 3,366 adults with schizophrenia exacerbation. Lurasidone 160 mg/day reduced Positive and Negative Syndrome Scale (PANSS) total scores significantly more than lurasidone 120, 80, 40, and 20 mg/day (mean differences = − 7.63, − 7.04, − 8.83, and − 12.25, respectively). All-cause dropout rates were significantly lower in participants receiving lurasidone 160 mg/day and 80 mg/day compared with those taking placebo. The half-maximal effective doses of lurasidone for PANSS total, PANSS positive, and MADRS score reductions were higher than 80 mg/day. The confidence of all NMA estimates was low or very low. Lurasidone 160 mg/day is currently the most efficacious and acceptable dose for acute schizophrenia. Its maximal effective doses may be higher than 160 mg/day.

Abstract This study aimed to determine: i) the correlation between objective and subjective cognition, ii) the correlates of objective and subjective cognition and iii) the predictors of discrepancy between objective and subjective cognition. Participants were non-elderly patients with major depressive disorder (MDD). We assessed subjective cognition using the Perceived Deficit Questionnaire for Depression (PDQ-D) and objective cognition using Face I and Face II tests of the Wechsler Memory Scale, 3rd edition and Digit Span and Matrix Reasoning tests of the Wechsler Intelligence Scale for Adults, 3rd edition. The discrepancy between objective and subjective cognition was estimated. Participants were 57 outpatients with MDD. PDQ-D scores were not correlated with composite neurocognitive test (NCT) z scores. Years of education significantly predicted composite NCT z scores, as did age. The 9-item Patient Health Questionnaire (PHQ-9) scores significantly predicted PDQ-D scores, as did antidepressant treatment. Age significantly predicted discrepancy scores, as did PHQ-9 scores. In conclusion, objective and subjective cognition in patients with MDD are not correlated. Age and education predict objective cognition. Depression. severity and antidepressant treatment predict subjective cognition. Age and depression severity may predict the discrepancy between objective and subjective cognition.

This study compared weight and cardiometabolic changes after short-term treatment of olanzapine/samidorphan and olanzapine. Eligible criteria for an included trial were ≤ 24 weeks, randomized controlled trials (RCTs) that compared olanzapine/samidorphan and olanzapine treatments in patients/healthy volunteers and reported weight or cardiometabolic outcomes. Three databases were searched on October 31, 2020. Primary outcomes included weight changes and all-cause dropout rates. Standardized mean differences (SMDs) and risk ratios (RRs) were computed and pooled using a random-effect model. This meta-analysis included four RCTs (n = 1195). The heterogeneous data revealed that weight changes were not significantly different between olanzapine/samidorphan and olanzapine groups (4 RCTs, SDM = - 0.19, 95% CI - 0.45 to 0.07, I 2  = 75%). The whole-sample, pooled RR of all-cause dropout rates (4 RCTs, RR = 1.02, 95% CI 0.84 to 1.23, I 2  = 0%) was not significant different between olanzapine/samidorphan and olanzapine groups. A lower percentage of males and a lower initial body mass index were associated with the greater effect of samidorphan in preventing olanzapine-induced weight gain. Current evidence is insufficient to support the use of samidorphan to prevent olanzapine-induced weight gain and olanzapine-induced cardiometabolic abnormalities. Samidorphan is well accepted by olanzapine-treated patients.

We compared the efficacy, safety, and acceptability of lurasidone at different doses to establish the dose-response relationships of lurasidone therapeutic and adverse effects in acute schizophrenia. Included trials were 4- to 16-week, fixed-dose, randomized controlled trials of lurasidone in adults with acute schizophrenia. Different doses of lurasidone, other antipsychotics, and placebo were considered as independent treatments. Apart from all-cause dropout rates, four therapeutic and four adverse outcomes were included in the frequentist network meta-analysis (NMA). Lurasidone 160, 120, 80, 40, and 20 mg/day were studied in ten trials of 3,366 adults with schizophrenia exacerbation. Lurasidone 160 mg/day reduced Positive and Negative Syndrome Scale (PANSS) total scores significantly more than lurasidone 120, 80, 40, and 20 mg/day (mean differences = - 7.63, - 7.04, - 8.83, and - 12.25, respectively). All-cause dropout rates were significantly lower in participants receiving lurasidone 160 mg/day and 80 mg/day compared with those taking placebo. The half-maximal effective doses of lurasidone for PANSS total, PANSS positive, and MADRS score reductions were higher than 80 mg/day. The confidence of all NMA estimates was low or very low. Lurasidone 160 mg/day is currently the most efficacious and acceptable dose for acute schizophrenia. Its maximal effective doses may be higher than 160 mg/day.

This study aimed to determine: i) the correlation between objective and subjective cognition, ii) the correlates of objective and subjective cognition and iii) the predictors of discrepancy between objective and subjective cognition. Participants were non-elderly patients with major depressive disorder (MDD). We assessed subjective cognition using the Perceived Deficit Questionnaire for Depression (PDQ-D) and objective cognition using Face I and Face II tests of the Wechsler Memory Scale, 3rd edition and Digit Span and Matrix Reasoning tests of the Wechsler Intelligence Scale for Adults, 3rd edition. The discrepancy between objective and subjective cognition was estimated. Participants were 57 outpatients with MDD. PDQ-D scores were not correlated with composite neurocognitive test (NCT) z scores. Years of education significantly predicted composite NCT z scores, as did age. The 9-item Patient Health Questionnaire (PHQ-9) scores significantly predicted PDQ-D scores, as did antidepressant treatment. Age significantly predicted discrepancy scores, as did PHQ-9 scores. In conclusion, objective and subjective cognition in patients with MDD are not correlated. Age and education predict objective cognition. Depression. severity and antidepressant treatment predict subjective cognition. Age and depression severity may predict the discrepancy between objective and subjective cognition.