Antipsychotic Medications: 44 Recent Meta-Analyses

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Antipsychotic Medications: 44 Meta-Analytic Studies Published in 2014-2018

Kenneth S. Pope, Ph.D., ABPP

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This site includes 3 other sets of recent meta-analytic resources:

For each brand name and generic antipsychotic medication, I searched out meta-analytic studies on its effectiveness, risks, side effects, differential effects on different populations, etc.--to help clinicians, expert witnesses, researchers, and others to stay abreast of the evolving research in this area. 

I focused on studies published in 2014-18, and included both the citation and a brief excerpt for each study:

  1. Andrade, C., et al. (2015). "Antipsychotic augmentation with modafinil or armodafinil for negative symptoms of schizophrenia: systematic review and meta-analysis of randomized controlled trials." J Psychiatr Res 60: 14-21.

    EXCERPT: Cognition, fatigue, daytime drowsiness, adverse events, and drop out rates did not differ significantly between ar/mod and placebo groups. Fixed and random effects models yielded similar results.... We conclude that ar/mod (200 mg/day) is safe and well tolerated in the short-term treatment of schizophrenia. Ar/mod reduces negative symptoms with a small effect size; the absolute advantage is also small, and the advantage disappears when chronically ill patients or those with high negative symptom burden are treated. Ar/mod does not benefit or worsen other symptom dimensions in schizophrenia."

  2. Correll, C. U., et al. (2016). "Efficacy for Psychopathology and Body Weight and Safety of Topiramate-Antipsychotic Cotreatment in Patients With Schizophrenia Spectrum Disorders: Results From a Meta-Analysis of Randomized Controlled Trials." J Clin Psychiatry 77(6): e746-756.

    EXCERPT: "Topiramate-antipsychotic cotreatment significantly reduced total, positive, negative, and general psychopathology and weight/BMI in patients with schizophrenia spectrum disorder while being well tolerated."

  3. Coughlin, C. G., et al. (2015). "Obstetric and neonatal outcomes after antipsychotic medication exposure in pregnancy." Obstet Gynecol 125(5): 1224-1235.

    EXCERPT: "Antipsychotic exposure was not associated with risk of large-for-gestational-age births, stillbirth, and spontaneous abortion. Although antipsychotic exposure during pregnancy was associated with increased risk of adverse obstetric and neonatal outcomes, this association does not necessarily imply causation.".

  4. Dold, M., et al. (2015). "Antipsychotic Augmentation of Serotonin Reuptake Inhibitors in Treatment-Resistant Obsessive-Compulsive Disorder: An Update Meta-Analysis of Double-Blind, Randomized, Placebo-Controlled Trials." Int J Neuropsychopharmacol 18(9).

    EXCERPT: "Antipsychotic augmentation of serotonin reuptake inhibitors can be regarded as an evidence-based measure in treatment-resistant obsessive-compulsive disorder."

  5. Dold et al. (2013). "Benzodiazepine augmentation of antipsychotic drugs in schizophrenia: A meta-analysis and cochrane review of randomized controlled trials." Eur Neuropsychopharmacol 23(9): 1023-1033.

    EXCERPT: "There is no evidence for antipsychotic efficacy of additional benzodiazepine medication in schizophrenia. Therefore, benzodiazepines should be considered primarily for desired ultra short-term sedation of acutely agitated patients but not for augmentation of antipsychotics in the medium- and long-term pharmacotherapy of schizophrenia and related disorders."

  6. Dold, M., et al. (2015). "Dose escalation of antipsychotic drugs in schizophrenia: a meta-analysis of randomized controlled trials." Schizophr Res 166(1-3): 187-193.

    EXCERPT: "This meta-analysis suggests no evidence for a dose-escalation of the investigated antipsychotic drugs fluphenazine, haloperidol, quetiapine, and ziprasidone in case of initial non-response to standard-dose pharmacotherapy."

  7. Dold, M., et al. (2015). "Second-Generation Antipsychotic Drugs in Anorexia Nervosa: A Meta-Analysis of Randomized Controlled Trials." Psychother Psychosom 84(2): 110-116.

    EXCERPT: "Based on the current evidence, pharmacological treatment of anorexia nervosa with SGAs cannot be generally recommended although some individuals or subgroups of patients might benefit from an antipsychotic medication."

  8. Faure Walker, N., et al. (2015). "Linking the evidence between urinary retention and antipsychotic or antidepressant drugs: A systematic review." Neurourol Urodyn.

    EXCERPT: "The majority of case reports reported an improvement in UR on discontinuation or dose reduction.... Antipsychotics and antidepressants interact with the urinary system in many ways. Clinicians treating acute UR need to keep in mind the role of antipsychotic and antidepressants as a precipitating cause.'

  9. Galling, B., et al. (2015). "Safety and tolerability of antipsychotic-mood stabilizer co-treatment in the management of acute bipolar disorder: results from a systematic review and exploratory meta-analysis." Expert Opin Drug Saf 14(8): 1181-1199.

    EXCERPT: "Pooled together, MS+AP versus MS monotherapy (studies = 18, n = 4419) was associated with significantly higher burden regarding 21/53 (39.6%) individual AEs, particularly weight gain-related (5/5 = 100%), extrapyramidal (5/12 = 41.7%) and glucose/lipid-related AEs (3/8 = 37.5%). AP+MS versus AP monotherapy (studies = 3, n = 397) was associated with significantly higher burden regarding 4/21 (19.0%) individual AEs (>/= 1 AE, tremor, sedation/somnolence, vomiting).... Efficacy advantages of AP+MS co-treatment versus monotherapy should be balanced with its greater AE burden. AE risk is higher for adding AP to MS (17 additional AEs) than adding MS to an AP, including the particularly concerning cardiometabolic AEs."

  10. Galling, B., et al. (2016). "Safety and tolerability of antipsychotic co-treatment in patients with schizophrenia: results from a systematic review and meta-analysis of randomized controlled trials." Expert Opin Drug Saf 15(5): 591-612.

    EXCERT: "No double-blind evidence for altered AE burden associated with antipsychotic co-treatment was found. However, AEs [Adverse Events] were insufficiently and incompletely reported and follow-up duration was modest. Adjunctive partial D2-agonists might be beneficial for counteracting several AEs."

  11. Han et al. (2014). The potential role of atypical antipsychotics for the treatment of posttraumatic stress disorder. Journal of Psychiatric Research, 56, 72-81.

    Excerpt: "AAs may have potential benefits for the treatment of PTSD as indicated by changes from baseline of the total score on the Clinician Administered PTSD Scale (CAPS; standardized mean difference [SMD] = −0.289, 95% confidence intervals [CIs] = −0.471, −0.106), P = 0.002). Additionally, AAs were found to be significantly more effective (P < 0.0001) than a placebo in terms of change from baseline for the intrusion sub-score on the CAPS (SMD = −0.373, 95% CIs = −0.568, −0.178) but there were no significant reductions for the avoidance and hyperarousal sub-symptoms. The responder rate and rate of improvement of depressive symptoms were also significantly higher in the AA group than the placebo group (P = 0.004 and P < 0.0001, respectively)."

  12. Kisely, S., et al. (2015). "A systematic review and meta-analysis of the effect of depot antipsychotic frequency on compliance and outcome." Schizophr Res 166(1-3): 178-186.

    EXCERPT: "There were no differences in psychotic symptoms or quality of life between two- and four-weekly doses. Health service use was not reported. For ADRs, the only significant difference detected was that two-weekly injections were less likely to lead to site pain..."

  13. Kishi, T., et al. (2016). "Antipsychotic medications for the treatment of delirium: a systematic review and meta-analysis of randomised controlled trials." J Neurol Neurosurg Psychiatry 87(7): 767-774.

    EXCERPT: "Our results suggested that SGAs have a benefit for the treatment of delirium with regard to efficacy and safety compared with haloperidol."

  14. Kishi, T., et al. (2016). "Long-acting injectable antipsychotics for the prevention of relapse in patients with recent-onset psychotic disorders: A systematic review and meta-analysis of randomized controlled trials." Psychiatry Research 246: 750-755.

    EXCERPT: "Pooling the studies, there were no significant differences between LAI-APs and OAPs in the improvement of Positive and Negative Syndrome Scale scores or in discontinuation due to all-cause, adverse events (AEs), and death, but LAI-APs outperformed OAPs in terms of discontinuation due to inefficacy (RR = 0.34, NNT = ?50) and nonadherence (RR = 0.30, NNT = ?33). However, the LAI-APs were associated with a higher incidence of at least one AE (RR = 1.13) and tremor (RR = 2.38) compared with OAPs."

  15. Krause, M., et al. (2018). "Antipsychotic drugs for patients with schizophrenia and predominant or prominent negative symptoms: A systematic review and meta-analysis." European Archives of Psychiatry and Clinical Neuroscience.

    EXCERPT: " In patients with prominent negative symptoms, olanzapine and quetiapine were superior to risperidone in single trials. Overall, studies in prominent negative symptoms were potentially more confounded by improvements of secondary negative symptoms.Interpretation: Amisulpride is the only antipsychotic that outperformed placebo in the treatment of predominant negative symptoms, but there was a parallel reduction of depression. Cariprazine was better than risperidone in a large trial that was well-controlled for secondary negative symptoms, but the trial was sponsored by its manufacturer. Future trials should apply scientifically developed definitions such as the deficit syndrome and the persistent negative symptoms concept."

  16. Lao, K. S. J., et al. (2016). "Tolerability and safety profile of cariprazine in treating psychotic disorders, bipolar disorder and major depressive disorder: A systematic review with meta-analysis of randomized controlled trials." CNS Drugs 30(11): 1043-1054.

    There was a statistically significant higher risk of EPS-related AEs and a slight increase in mean body weight with cariprazine. There were no statistically significant effects on prolactin level or cardiovascular parameters. EPSs were the main short-term adverse reactions reported in the limited number of patients studied.

  17. Leucht, S., et al. (2017). "Sixty years of placebo-controlled antipsychotic drug trials in acute schizophrenia: Systematic review, Bayesian meta-analysis, and meta-regression of efficacy predictors." The American Journal of Psychiatry 174(10): 927-942.

    EXCERPT: "Antipsychotics differed substantially in side effects. Of the response predictors analyzed, 16 trial characteristics changed over the decades. However, in a multivariable meta-regression, only industry sponsorship and increasing placebo response were significant moderators of effect sizes. Drug response remained stable over time....  Approximately twice as many patients improved with antipsychotics as with placebo, but only a minority experienced a good response. Effect sizes were reduced by industry sponsorship and increasing placebo response, not decreasing drug response.

  18. Liu et al. (2014). Efficacy and acceptability of atypical antipsychotics for the treatment of post-traumatic stress disorder: A meta-analysis of randomized, double-blind, placebo-controlled clinical trials. Psychiatry Research.

    EXCERPT: "AAs may be superior to placebo in the treatment of PTSD, as indicated by the changes in Clinician Administered PTSD Scale (CAPS) total scores (weighted mean differences (WMD)=−5.89, 95% confidence interval (CI) [−9.21, −2.56], P=0.0005) and also in CAPS subscale intrusion (WMD=−2.58, 95% CI[−3.83, −1.33], P<0.0001 ) and subscale hyperarousal (WMD=−2.94, 95% CI[−5.45, −0.43], P=0.02)."

  19. Meng, M., et al. (2015). "Using aripiprazole to reduce antipsychotic-induced hyperprolactinemia: meta-analysis of currently available randomized controlled trials." Shanghai Arch Psychiatry 27(1): 4-17.

    EXCERPT: "This study systematically reviewed and evaluated all relevant RCTs and found that adjunctive aripiprazole is effective and safe to use in the treatment of antipsychotic-induced HPL. However, the low quality of some of the studies, the incomplete methodological information provided for most of the studies, and the relatively short follow-up time of the studies raises question about the validity of the results."

  20. Misawa, F., et al. (2016). "Safety and tolerability of long-acting injectable versus oral antipsychotics: A meta-analysis of randomized controlled studies comparing the same antipsychotics." Schizophrenia Research 176(2-3): 220-230.

    EXCERPT: "LAIs and OAPs did not differ on all serious and > 90% of individual adverse events."

  21. Neufeld, K. J., et al. (2016). "Antipsychotic Medication for Prevention and Treatment of Delirium in Hospitalized Adults: A Systematic Review and Meta-Analysis." J Am Geriatr Soc 64(4): 705-714.

    EXCERPT: "Using data reported from all 19 studies, antipsychotic use was not associated with change in delirium duration, severity, or hospital or ICU LOS, with high heterogeneity among studies. No association with mortality was detected…. Current evidence does not support the use of antipsychotics for prevention or treatment of delirium."

  22. Nielsen, R. E., et al. (2015). "Second-generation antipsychotic effect on cognition in patients with schizophrenia--a meta-analysis of randomized clinical trials." Acta Psychiatr Scand 131(3): 185-196.

    EXCERPT: "On cognitive composite score, sertindole was superior to clozapine, effect size (ES) 0.87; 95% CI: 0.12-1.63, quetiapine, ES 0.75; 95% CI: 0.00-1.49, and first-generation antipsychotics (FGAs), ES 0.89; 95% CI: 0.14-1.64. Analyses on each cognitive domain showed clozapine, ES 0.37; 95% CI: 0.00-0.74, olanzapine, ES 0.31; 95%CI: 0.02-0.59, quetiapine, ES 0.34; 95% CI: 0.03-0.64, and FGAs, ES 0.51; 95% CI: 0.18-0.83 performing poorer on verbal working memory than ziprasidone, as well as FGAs performing poorer than risperidone, ES 0.31; 95% CI: 0.04-0.58. On executive function, sertindole performed better than clozapine, ES 0.82; 95% CI: 0.06-1.58, olanzapine, ES 0.81; 95% CI: 0.07-1.55, quetiapine, ES 0.76; 95% CI: 0.02-1.51, ziprasidone, ES 0.90; 95% CI: 0.14-1.67, and FGAs, ES 0.83; 95% CI: 0.08-1.58. On processing speed, FGAs performed poorer than sertindole, ES 0.97; 95% CI: 0.02-1.91, and quetiapine, ES 0.36; 95% CI: 0.01-0.72. On long-term verbal working memory, clozapine performed poorer than olanzapine, ES 0.41; 95% CI: 0.06-0.76. On verbal fluency, FGAs performed poorer than olanzapine, ES 0.26; 95% CI: 0.01-0.50, and clozapine, ES 0.44; 95% CI: 0.06-0.81. Lastly, FGAs, ES 0.41; 95% CI: 0.04-0.78, and clozapine, ES 0.44; 95% CI: 0.05-0.83, performed poorer on visuospatial skill compared to olanzapine.... The meta-analysis was able to detect some trends in the data analyzed, but did not show any drug having a uniform positive cognitive profile."

  23. Nose, M., et al. (2015). "Antipsychotic drug exposure and risk of pneumonia: a systematic review and meta-analysis of observational studies." Pharmacoepidemiol Drug Saf 24(8): 812-820.

    EXCERPT: "Systematic review of current observational evidence suggests that exposure to first-generation and second-generation AP drugs is associated with an increased risk of pneumonia. The present systematic review expands previous knowledge by showing that the increased risk not only applies to elderly individuals but also to younger patients."

  24. Okuyama, Y., et al. (2016). "Efficacy and tolerability of topiramate-augmentation therapy for schizophrenia: A systematic review and meta-analysis of randomized controlled trials." Neuropsychiatric Disease and Treatment 12.

    EXCERPT: " Our results seemed to suggest that topiramate-augmentation therapy improves the psychopathology of schizophrenia with good tolerability and has the additional advantage of weight maintenance."

  25. Pagsberg, A. K., et al. (2017). "Acute antipsychotic treatment of children and adolescents with schizophrenia-spectrum disorders: A systematic review and network meta-analysis." Journal of the American Academy of Child & Adolescent Psychiatry 56(3): 191-202.

    EXCERPT: "This network meta-analysis showed comparable efficacy among antipsychotics for early-onset schizophrenia, except that efficacy appeared inferior for ziprasidone and unclear for asenapine. Adverse reaction profiles varied substantially among the investigated antipsychotics and were largely consistent with prior findings in adults."

  26. Park, S. Y., et al. (2016). "Antipsychotic Use Trends in Youth With Autism Spectrum Disorder and/or Intellectual Disability: A Meta-Analysis." J Am Acad Child Adolesc Psychiatry 55(6): 456-468 e454.

    EXCERPT: "Almost 1 in 10 antipsychotic-treated youth were diagnosed with ASD and/or ID, and 1 in 6 youth with ASD received antipsychotics. Both proportions increased in later years…."

  27. Potvin, S., et al. (2015). "Antipsychotic-induced changes in blood levels of leptin in schizophrenia: a meta-analysis." Can J Psychiatry 60(3 Suppl 2): S26-34.

    EXCERPT: "A moderate and positive effect size was observed across studies. Olanzapine, clozapine, and quetiapine produced moderate leptin elevations, whereas haloperidol and risperidone were associated with small (nonsignificant) leptin changes. Across studies, BMI changes were significantly associated with increases in leptin levels. There was no effect of sex on AP-induced changes in leptin. .... A physiological role of leptin in AP-induced weight gain is supported because the most significant leptin increases were observed with APs inducing the most weight gain and because of the observed association between leptin increases and BMI changes. The overall increase in leptin levels suggests that leptin acts as a negative feedback signal in the event of fat increase."

  28. Rao, A., et al. (2016). "Meta?analysis of population?based studies comparing risk of cerebrovascular accident associated with first? and second?generation antipsychotic prescribing in dementia." International Journal of Methods in Psychiatric Research 25(4): 289-298.

    EXCERPT: "Second-generation antipsychotics (SGAs) are often prescribed in the treatment of Behavioral and Psychological Symptoms of Dementia (BPSD), however, their use has been discouraged in light of clinical trials suggesting that they cause an increased risk of cerebrovascular accidents (CVAs)…. Meta-analysis of population-based data suggested that the use of SGAs as opposed to FGAs to control BPSD is not associated with significantly increased risk of CVA."

  29. Samara et al. (2014). Chlorpromazine versus every other antipsychotic for schizophrenia: A systematic review and meta-analysis challenging the dogma of equal efficacy of antipsychotic drugs. European Neuropsychopharmacology.

    EXCERPT: "Chlorpromazine was compared with 43 other antipsychotics and was more efficacious than four (butaperazine, mepazine, oxypertine and reserpine) and less efficacious than other four antipsychotics (clomacran, clozapine, olanzapine and zotepine) in the primary outcome. There were no statistically significant efficacy differences between chlorpromazine and the remaining 28 antipsychotics. The most important finding was that, due to low numbers of participants (median 50, range 8–692), most comparisons were underpowered. Thus we infer that the old antipsychotic drug literature was inconclusive and the claim for equal efficacy of antipsychotics was never evidence-based."

  30. Sikirica et al. (2014). Risk of death associated with the use of conventional vs. atypical antipsychotic medications: Evaluating the use of the emilia-romagna region database for pharmacoepidemiological studies. Journal of Clinical Pharmacy and Therapeutics, 39(1), 38-44.

    EXCERT: "Among 14,462 and 9,219 patients prescribed conventional and atypical antipsychotics, respectively, we observed 2,402 (16·6%) and 821 (8·9%) deaths during follow-up. Conventional antipsychotic initiators were older and generally had higher prevalence of outcome risk factors and higher baseline health service use intensity. The crude hazard ratio (HR) was 1·95, which decreased to 1·47...after full adjustment. We identified seven published studies that examined this association using similar methods. The pooled HR from these studies was 1·34.... Our results support the use of the RER database for pharmacoepidemiological studies and provide an up-to-date and pooled estimate of the magnitude of the association between mortality and conventional vs. atypical antipsychotics."

  31. Takeuchi, H., et al. (2017). "Gradual vs. Wait-and-gradual discontinuation in antipsychotic switching: A meta-analysis." Schizophrenia Research. Published online in advance of print publication.

    EXCERPT: "The meta-analysis of 5 studies (n=410) demonstrated no significant differences in any clinical outcomes, including study discontinuation, psychopathology, extrapyramidal symptoms, and treatment-emergent adverse events, between the two groups. These findings indicate either strategy can be used in clinical practice."

  32. Tan, L., et al. (2015). "Efficacy and safety of atypical antipsychotic drug treatment for dementia: a systematic review and meta-analysis." Alzheimers Res Ther 7(1): 20.

    EXCERPT: "Aripiprazole and risperidone are able to improve psychiatric symptoms and slow decline in cognition function at average 12 weeks in patients with neuropsychiatric symptoms of dementia. However, high adverse events may offset the efficacy of atypical antipsychotics in dementia."

  33. Tek, C., et al. (2016). "Antipsychotic-induced weight gain in first-episode psychosis patients: a meta-analysis of differential effects of antipsychotic medications." Early Interv Psychiatry 10(3): 193-202.

    EXCERPT: "Except for ziprasidone, most AP medications were associated with body weight gain and BMI increase in FEP patients. Early and continuing effects of various AP medications on weight gain and BMI increase should be taken into consideration by clinicians."

  34. van Schalkwyk, G. I., et al. (2018). "Antipsychotics for aggression in adults: A meta-analysis." Progress in Neuro-Psychopharmacology & Biological Psychiatry 81: 452-458.

    EXCERPT: "Although antipsychotics appear to be effective for treatment of aggression, their small effect sizes in the context of their significant side-effects should be taken into account when making clinical decisions about their use."

  35. Vita, A., et al. (2015). "The Effect of Antipsychotic Treatment on Cortical Gray Matter Changes in Schizophrenia: Does the Class Matter? A Meta-analysis and Meta-regression of Longitudinal Magnetic Resonance Imaging Studies." Biol Psychiatry 78(6): 403-412.

    EXCERPT: "Over time, patients with schizophrenia showed a significantly higher loss of total cortical GM volume. This was related to cumulative antipsychotic intake during the interval between scans in the whole study sample. Subgroup meta-analyses of studies on patients treated with second-generation antipsychotics and first-generation antipsychotics revealed a different and contrasting moderating role of medication intake on cortical GM changes: more progressive GM loss correlated with higher mean daily antipsychotic intake in patients treated with at least one first-generation antipsychotic and less progressive GM loss with higher mean daily antipsychotic intake in patients treated only with second-generation antipsychotics."

  36. Wang, H. R., et al. (2015). "Can Atypical Antipsychotic Augmentation Reduce Subsequent Treatment Failure More Effectively Among Depressed Patients with a Higher Degree of Treatment Resistance? A Meta-Analysis of Randomized Controlled Trials." Int J Neuropsychopharmacol 18(8).

    EXCERPT: "This finding strengthens the rationale for considering atypical antipsychotic augmentation among depressed patients with multiple previous treatment failures in clinical practice. The efficacy of atypical antipsychotic augmentation for non-TRD seems to be different from that for TRD and, thus, further studies of non-TRD populations are needed."

  37. Welten, C. C., et al. (2015). "Placebo response in antipsychotic trials of patients with acute mania: Results of an individual patient data meta-analysis." Eur Neuropsychopharmacol 25(7): 1018-1026.

    EXCERPT: "Our findings showed that the placebo response in efficacy trials of antipsychotics for acute mania is substantial and an important determinant of treatment effect. Placebo response is influenced by patient characteristics (illness severity and presence of psychotic features) and by study characteristics (study year, number of geographic regions and region). However, the prediction model could only explain the placebo response to a limited extent. Therefore, limiting trials to certain patients in certain geographic regions seems not a viable strategy to improve assay sensitivity."

  38. Wolf, A., et al. (2017). "Do antipsychotics lead to cognitive impairment in dementia? A meta?analysis of randomised placebo?controlled trials." European Archives of Psychiatry and Clinical Neuroscience 267(3): 187-198.

    EXCERPT: " The random effects model of the pooled analysis showed a not significant effect (SMD = ?0.065, 95 % CI ?0.186 to 0.057, I2 = 41 %). Meta-regression revealed a significant correlation between cognitive impairment and treatment duration (R2 = 0.78, p < 0.02) as well as baseline MMSE (R2 = 0.92, p < 0.005). These correlations depend on only two out of ten studies and should interpret cautiously."

  39. Zhai, Y., et al. (2016). "Association between Antipsychotic Drugs and Mortality in Older Persons with Alzheimer's Disease: A Systematic Review and Meta-Analysis." J Alzheimers Dis 52(2): 631-639.

    EXCERPT: "The result of one double-blind randomized clinical trial indicated that antipsychotic drugs nearly doubled the risk of death in AD patients. In conclusion, there is no evidence of absence of association between antipsychotic drugs' use with death risk of AD patients. Careful assessments of potential benefits and risks should be made before prescribing antipsychotics for treatment of psychosis symptoms and behavioral problems of AD patients."

  40. Zheng, W., et al. (2018). "Adjunctive azapirone for schizophrenia: A meta-analysis of randomized, double-blind, placebo-controlled trials." European Neuropsychopharmacology 28(1): 149-158.

    EXCERPT: "Adjunctive buspirone and tandospirone failed to show efficacy for psychotic symptoms, but adjunctive buspirone may be associated with improvement in extrapyramidal symptoms and cognitive deficits in schizophrenia."

  41. Zheng, W., et al. (2016). "Efficacy and safety of adjunctive topiramate for schizophrenia: A meta-analysis of randomized controlled trials." Acta Psychiatrica Scandinavica 134(5): 385-398.

    EXCERPT: "These results indicate that adjunctive topiramate to antipsychotics is an effective and safe treatment choice for symptomatic improvement and weight reduction in patients with schizophrenia-spectrum disorders."

  42. Zheng, W., et al. (2016). "Efficacy and safety of adjunctive aripiprazole in schizophrenia: Meta-analysis of randomized controlled trials." Journal of Clinical Psychopharmacology 36(6): 628-636.

    EXCERPT: "Aripiprazole outperformed the comparison interventions for body weight in 9 RCTs (N = 505) with a WMD of ?5.08 kg (95% CI, ?7.14 to ?3.02; P< 0.00001; I2 = 35%) and for body mass index (BMI) in 14 RCTs (N = 809) with a WMD of ?1.78 (CI: ?2.25 to ?1.31; P< 0.00001; I2 = 54%). The BMI meta-regression analysis indicated aripiprazole's association with lower BMI was stronger in females. Adjunctive aripiprazole appears safe but better RCTs are needed to demonstrate efficacy. "

  43. Zhang, Y., et al. (2017). "Metabolic side effects of 12 antipsychotic drugs used for the treatment of schizophrenia on glucose: A network meta-analysis." BMC Psychiatry 17.

    EXCERPT: "Olanzapine was associated with a significantly greater change in blood glucose levels than ziprasidone, lurasidone, risperidone or placebo treatment. The application of a hierarchy of glucose metabolism-related side effects may help clinicians tailor the choice of antipsychotic drug to meet the needs of individual patients."

  44. Zhou, X. P., et al. (2015). "Atypical Antipsychotic Augmentation for Treatment-Resistant Depression: A Systematic Review and Network Meta-Analysis." Int J Neuropsychopharmacol 18(11).

    EXCERPT: "All standard-dose atypical antipsychotics for the adjunctive treatment of TRD are efficacious in reducing depressive symptoms. Risperidone and aripiprazole also showed benefits in improving the quality of life of patients. Atypical antipsychotics should be prescribed with caution due to abundant evidence of side effects."

This site includes 3 other sets of recent meta-analytic resources:



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