Comparative efficacy and tolerability of 32 oral and long-acting injectable antipsychotics for the maintenance treatment of adults with schizophrenia: a systematic review and network meta-analysis

Schneider‐Thoma, Johannes; Chalkou, Konstantina; Dörries, Carola; Bighelli, Irene; Ceraso, Anna; Huhn, Maximilian; Siafis, Spyridon; Davis, John M.; Cipriani, Andrea; Furukawa, Toshi A; Salanti, Georgia; Leucht, Stefan

doi:10.1016/s0140-6736(21)01997-8

Cited by 142 publications

(144 citation statements)

References 38 publications

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“…In our study, patients with SMD treated with clozapine and aripiprazole were more likely to be overweight and obesity, while patients with SMD treated with perphenazine, risperidone, Aripiprazole and amsulfamide were to be obesity. This nding is consistent with most research reports that antipsychotics might reduce the body's caloric consumption, leading to increased appetite in patients who, in turn, lack su cient exercise, leading to weight gain [40][41][42][43]. Previous studies have reported [9,44,45] that obesity and overweight can lead to vascular aging, dyslipidemia and carotid atherosclerosis, impaired glucose tolerance and abnormal blood glucose, increasing the risk of hypertension [46], coronary atherosclerotic heart disease [47], type 2 diabetes [48],…”

Section: Discussionsupporting

confidence: 90%

“…Although antipsychotic drugs can better for treat psychiatric disorders, they can also cause a number of problems such as metabolic disorders [40][41][42]. In our study, patients with SMD treated with clozapine and aripiprazole were more likely to be overweight and obesity, while patients with SMD treated with perphenazine, risperidone, Aripiprazole and amsulfamide were to be obesity.…”

Section: Discussionmentioning

confidence: 56%

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Prevalence and factors associated with overweight and obesity in patients with severe mental disorders in Shenzhen: results from the urban Chinese population

Peng

Shan

Zhou

et al. 2022

Preprint

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Background: Although overweight and obesity are important risk factors for the physical health of severe mental disorders (SMD), few studies have been reported. Morbidity and mortality associated with physical disorders of SMD can be reduced if detected and managed in the early stages of physical disorders. The objective was to analyse the prevalence of overweight and obesity in patients with SMD and factors associated with sociodemographic and disease characteristics in a cross-sectional population-based study.Methods: This analysis examined prevalence of overweight and obesity of 14,868 managed SMD patients in urban area of Shenzhen city, based on data from the information monitoring system in 2020. Sociodemographical and physiological characteristics of overweight and obesity of SMD patients were described. The multivariate logistic regression models were used to identify the factors associated with the prevalence of overweight and obesity of SMD.Results: Records of 14, 868 participants were included for analysis. The prevalence of overweight and obesity in patients with SMD in this study was 32.6% and 16.1%, respectively. In multivariate analysis, married, Shenzhen household registration, number of years of management 5-10 years and >10 years, participation in family physician services, taking clozapine or aripiprazole, FPG>6.1 mmol/L, hypertension, TC≥5.2mmol/L, TG≥1.7mmol/L, the more frequent the number of follow-ups in the past year were associated with higher odds of overweight and obesity, while older, having tertiary education, and mental retardation with mental disorders had lower odds of overweight and obesity. Compared to their respective reference categories, living status with parents, spouse and children, taking risperidone, aripiprazole, amisulpride and perphenazine, FPG>6.1 mmol/L, hypertension, TC≥5.2mmol/L, TG≥1.7mmol/L, the more frequent the number of follow-ups in the past year were associated with higher odds of obesity, while having tertiary education and schizophrenia had lower odds of obesity. Conclusions: We observed a high prevalence of overweight and obesity with SMD in this study. The findings highlight the need for integrated management of overweight and obesity risk factors among patients with SMD.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 56%

Prevalence and factors associated with overweight and obesity in patients with severe mental disorders in Shenzhen: results from the urban Chinese population

Peng

Shan

Zhou

et al. 2022

Preprint

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“…The decision to select an antipsychotic for treatment depends on an informed risk-benefit analysis of each individual patient’s condition and needs, including consideration of efficacy and a range of potential side effects. Systematic reviews and meta-analyses show that in general, FGAs and SGAs, have comparable efficacy with differences that are on a continuum rather than discrete [ 148 149 ]. Research and development of antipsychotic drugs has largely been driven by the goal of eliminating adverse DIMD, especially irreversible tardive syndromes, while preserving antipsychotic effectiveness.…”

Section: Discussionmentioning

confidence: 99%

Risk of Drug-induced Movement Disorders with Newer Antipsychotic Agents

Kannarkat

Caroff

Morley

2022

Tremor and Other Hyperkinetic Movements

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Background: The last decade has seen development of numerous novel antipsychotic drugs with unique mechanisms including long-acting formulations for clinical use. A comparative assessment of these new drugs with each other and previous antipsychotics have not been performed with regards to risk for drug-induced movement disorders (DIMD). Methods: Medline was searched from January 2010 to February 2022 for primary research articles and review articles in English using the search terms “extrapyramidal” and “tardive” with individual drug names of novel antipsychotics. Results: We identified articles describing the risk of DIMD with 6 novel antipsychotics, 4 novel formulations, and 3 experimental antipsychotics. Both short- and long-term data generally showed comparable to lower risk of DIMD with novel antipsychotics and recent long-acting formulations compared to previously marketed antipsychotics. Discussion: Several novel antipsychotics, particularly lumateperone and pimavanserin, show promise in being able to treat psychosis while reducing the risk of DIMD. Long-acting paliperidone may reduce risk of DIMD while other long-acting injectable formulations of SGA have similar risk of DIMD compared to oral formulations. New drug targets for treating psychosis without dopamine blockade also show promise.

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“…Schizophrenia is a serious psychiatric illness that affects approximately one in a hundred people worldwide (1)(2)(3)(4)(5). The rate of early mortality is 2-to 3-fold higher in patients with schizophrenia than that in the general population (6)(7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

The schizophrenia and gut microbiota: A bibliometric and visual analysis

Yang

Lin²,

Wang³

et al. 2022

Front. Psychiatry

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BackgroundMany studies have explored the link between the gut microbiota and schizophrenia. To date, there have been no bibliometric analyses to summarize the association between the gut microbiota and schizophrenia. We aimed to conduct a bibliometric study of this association to determine the current status and areas for advancement in this field.Materials and methodsPublications related to the gut microbiota and schizophrenia were retrieved from the Web of Science Core Collection (WoSCC). The WoSCC literature analysis wire and VOSviewer 1.6.16 were used to conduct the analysis.ResultsIn total, 162 publications were included in our study. The publications generally showed an upward trend from 2014. A total of 873 authors from 355 organizations and 40 countries/regions contributed to this field. The leading authors were Timothy Dinan, John F Cryan, and Emily Severance. The leading institutions were Johns Hopkins University, the University College Cork, and the University of Toronto. The most productive countries were the United States (US), China, and Canada. In total, 95 journals contributed to this field. Among them, the top three productive journals were Schizophrenia Research, Progress in Neuro Psychopharmacology Biological Psychiatry, and Frontiers in Psychiatry. The important keywords in the clusters were gut microbiome, bipolar disorder, schizophrenia, antipsychotics, weight gain, metabolic syndrome, gut-brain axis, autism, depression, inflammation, and brain.ConclusionThe main research hotspots involving the connection between schizophrenia and the gut microbiota were the characteristics of the microbiota composition in schizophrenia patients, the gut-brain axis, and microbial-based interventions for schizophrenia. The studies about the association between gut microbiota and schizophrenia are limited, and more studies are needed to provide new insights into the gut microbiota in the pathogenesis and treatment of schizophrenia.

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Comparative efficacy and tolerability of 32 oral and long-acting injectable antipsychotics for the maintenance treatment of adults with schizophrenia: a systematic review and network meta-analysis

Cited by 142 publications

References 38 publications

Prevalence and factors associated with overweight and obesity in patients with severe mental disorders in Shenzhen: results from the urban Chinese population

Prevalence and factors associated with overweight and obesity in patients with severe mental disorders in Shenzhen: results from the urban Chinese population

Risk of Drug-induced Movement Disorders with Newer Antipsychotic Agents

The schizophrenia and gut microbiota: A bibliometric and visual analysis

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