Selective Serotonin 3 Receptor Antagonist Treatment for Schizophrenia: Meta-analysis and Systematic Review

详细信息    查看全文

• 作者：Taro Kishi (1)
  Tomohiko Mukai (1)
  Yuki Matsuda (1)
  Nakao Iwata (1)
  
• 关键词：Schizophrenia ; Serotonin 3 receptor antagonists ; Meta ; analysis ; Granisetron ; Ondansetron ; Tropisetron
• 刊名：NeuroMolecular Medicine
• 出版年：2014
• 出版时间：March 2014
• 年：2014
• 卷：16
• 期：1
• 页码：61-69
• 全文大小：571 KB
• 作者单位：Taro Kishi (1)
  Tomohiko Mukai (1)
  Yuki Matsuda (1)
  Nakao Iwata (1)
  
  1. Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, 470-1192, Japan
  
• ISSN：1559-1174

文摘

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?=??.03, CI?=??.70 to ?.36, p?=?0.003 (I 2?=?82?%, 5 studies, n?=?261); on negative scores were SMD?=??.10, CI?=??.82 to ?.39, p?=?0.002 (I 2?=?84?%, 5 studies, n?=?261); and on PANSS general scores were SMD?=??.70, CI?=??.23 to ?.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?=??.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-.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.