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Selective serotonin 3 receptor antagonist treatment for schizophrenia: meta-analysis and systematic review.
- Source :
-
Neuromolecular medicine [Neuromolecular Med] 2014 Mar; Vol. 16 (1), pp. 61-9. Date of Electronic Publication: 2013 Jul 30. - Publication Year :
- 2014
-
Abstract
- Double-blinded, randomized, placebo-control trials of selective serotonin 3 receptor antagonists (5-HT3R-ANTs) for schizophrenia have differed in outcome. This meta-analysis tests the hypothesis that 5-HT3R-ANTs are effective for the treatment for schizophrenia. We searched PubMed, the Cochrane Library database, and PsycINFO up to June 15, 2013. We conducted a systematic review and meta-analysis of individual patient data from randomized controlled trials comparing 5-HT3R-ANTs add-on therapy with placebo. The risk ratio (RR), 95 % confidence intervals (CI), and standardized mean difference (SMD) were calculated. A random-effects model was used. Six studies (total n = 311) were identified. These included one granisetron plus risperidone study, one ondansetron plus risperidone study, one ondansetron plus haloperidol, and three tropisetron plus risperidone studies. The statistically significant effects of 5-HT3R-ANTs add-on therapy on Positive and Negative Syndrome Scale (PANSS) total scores were SMD = -1.03, CI = -1.70 to -0.36, p = 0.003 (I (2) = 82 %, 5 studies, n = 261); on negative scores were SMD = -1.10, CI = -1.82 to -0.39, p = 0.002 (I (2) = 84 %, 5 studies, n = 261); and on PANSS general scores were SMD = -0.70, CI = -1.23 to -0.17, p = 0.01 (I (2) = 73 %, 5 studies, n = 261). However, 5-HT3R-ANTs add-on therapy was not superior to placebo in PANSS positive scores (SMD = -0.12, p = 0.33). Dropout due to all cause (RR = 0.80, p = 0.50), inefficacy (RR = 0.76, p = 0.65), or adverse events (RR = 0.84, p = 0.75) was similar in both groups. Constipation occurred significantly more often with 5-HT3R-ANTs than placebo (RR = 2.05, CI = 1.07-3.91, p = 0.03, NNH = 11, p = 0.02). 5-HT3R-ANTs add-on therapy is more beneficial on the psychopathology (especially negative symptoms) than controls in patients with schizophrenia, and 5-HT3R-ANTs seem to be well-tolerated treatments.
- Subjects :
- Antipsychotic Agents administration & dosage
Antipsychotic Agents adverse effects
Constipation chemically induced
Double-Blind Method
Drug Therapy, Combination
Granisetron adverse effects
Granisetron therapeutic use
Haloperidol administration & dosage
Haloperidol therapeutic use
Humans
Indoles adverse effects
Indoles therapeutic use
Nausea chemically induced
Ondansetron adverse effects
Ondansetron therapeutic use
Randomized Controlled Trials as Topic
Receptors, Serotonin, 5-HT3 drug effects
Receptors, Serotonin, 5-HT3 physiology
Risperidone administration & dosage
Risperidone therapeutic use
Serotonin 5-HT3 Receptor Antagonists administration & dosage
Serotonin 5-HT3 Receptor Antagonists adverse effects
Severity of Illness Index
Symptom Assessment
Treatment Outcome
Tropisetron
Vomiting chemically induced
Antipsychotic Agents therapeutic use
Schizophrenia drug therapy
Serotonin 5-HT3 Receptor Antagonists therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1559-1174
- Volume :
- 16
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Neuromolecular medicine
- Publication Type :
- Academic Journal
- Accession number :
- 23896722
- Full Text :
- https://doi.org/10.1007/s12017-013-8251-0