Adjunctive Reboxetine for Schizophrenia: Meta-analysis of Randomized Double-blind, Placebo-controlled Trials.

Abstract

BACKGROUND:

Results of previous studies on the safety and efficacy of adjunctive reboxetine for schizophrenia have been inconsistent.

AIM:

The aim of this study was to examine the efficacy and tolerability of reboxetine as an adjunct medication to antipsychotic treatment in a meta-analysis of randomized controlled trials (RCTs).

METHODS:

Two independent investigators extracted data for a random effects meta-analysis and assessed the quality of studies using risk of bias and the Jadad scale. Weighted and standardized mean differences (WMDs/SMDs) and risk ratio (RR)±95% confidence intervals (CIs) were calculated.

RESULTS:

Nine RCTs (n=630) with double-blind design were identified. Reboxetine outperformed placebo in improving negative (9 RCTs, n=602, SMD: -0.47 [95% CI: -0.87, -0.07], p=0.02; I2=82%), but not the overall, positive, and general psychopathology scores. The significant therapeutic effect on negative symptoms disappeared in the sensitivity analysis after removing an outlying study and in 50% (6/12) of the subgroup analyses. Reboxetine outperformed placebo in reducing weight (3 RCTs, n=186, WMD: -3.83 kg, p=0.04; I2=92%) and body mass index (WMD: -2.23 kg/m2, p=0.04; I2=95%). Reboxetine caused dry mouth but was associated with less weight gain overall and weight gain of ≥7% of the initial weight. All-cause discontinuation and other adverse events were similar between reboxetine and placebo.

CONCLUSION:

Adjunctive reboxetine could be useful for attenuating antipsychotic-induced weight gain, but it was not effective in treating psychopathology including negative symptoms in schizophrenia.

• Authors: Wei Zheng, Xian-Bin Li, Zhan-Ming Shi, Xin-Hu Yang, Dong-Bin Cai, Chee H Ng, Gabor S Ungvari, Wei-Jian Liu, Yu-Jie Wu, Yuan-Yuan Wang, Yu-Ping Ning, Yu-Tao Xiang
• Journal: Pharmacopsychiatry (Pharmacopsychiatry) Vol. 53 Issue 1 Pg. 5-13 (Jan 2020) ISSN: 1439-0795 [Electronic] Germany
• PMID: 31207653 (Publication Type: Journal Article, Meta-Analysis)
• Copyright: © Georg Thieme Verlag KG Stuttgart · New York.

Chemical References

• Antipsychotic Agents
• Reboxetine

Topics

• Adult
• Antipsychotic Agents (administration & dosage, adverse effects, therapeutic use)
• Body Mass Index
• Cognition
• Double-Blind Method
• Drug Therapy, Combination
• Female
• Humans
• Male
• Middle Aged
• Patient Dropouts
• Randomized Controlled Trials as Topic
• Reboxetine (administration & dosage, adverse effects, therapeutic use)
• Schizophrenia (drug therapy)