Examining Side Effect Variability of Antipsychotic Treatment in Schizophrenia Spectrum Disorders: A Meta-analysis of Variance.
QTc prolongation
adverse effects
antipsychotics
precision medicine
prolactin
variability
weight gain
Journal
Schizophrenia bulletin
ISSN: 1745-1701
Titre abrégé: Schizophr Bull
Pays: United States
ID NLM: 0236760
Informations de publication
Date de publication:
21 10 2021
21 10 2021
Historique:
pubmed:
11
8
2021
medline:
11
2
2022
entrez:
10
8
2021
Statut:
ppublish
Résumé
Side effects of antipsychotic drugs play a key role in nonadherence of treatment in schizophrenia spectrum disorders (SSD). While clinical observations suggest that side effect variability between patients may be considerable, statistical evidence is required to confirm this. Here, we hypothesized to find larger side effect variability under treatment compared with control. We included double-blind, placebo-controlled, randomized controlled trials (RCTs) of adults with a diagnosis of SSD treated with 1 out of 14 antipsychotics. Standard deviations of the pre-post treatment differences of weight gain, prolactin levels, and corrected QT (QTc) times were extracted. The outcome measure was the variability ratio of treatment to control for individual antipsychotic drugs and the overall variability ratio of treatment to control across RCTs. Individual variability ratios were weighted by the inverse-variance method and entered into a random-effects model. We included N = 16 578 patients for weight gain, N = 16 633 patients for prolactin levels, and N = 10 384 patients for QTc time. Variability ratios (VR) were significantly increased for weight gain (VR = 1.08; 95% CI: 1.02-1.14; P = .004) and prolactin levels (VR = 1.38; 95% CI: 1.17-1.62; P < .001) but did not reach significance for QTc time (VR = 1.05; 95% CI: 0.98-1.12; P = 0.135). We found marked differences between individual antipsychotics and increased variability in side effects in patients under treatment with antipsychotics suggesting that subgroups of patients or individual patients may benefit from treatment allocation through stratified or personalized medicine.
Identifiants
pubmed: 34374418
pii: 6347162
doi: 10.1093/schbul/sbab078
pmc: PMC8530397
doi:
Substances chimiques
Antipsychotic Agents
0
Prolactin
9002-62-4
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1601-1610Informations de copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Références
Arch Gen Psychiatry. 2003 Jul;60(7):681-90
pubmed: 12860772
Psychopharmacology (Berl). 1996 Mar;124(1-2):168-75
pubmed: 8935813
J Clin Psychopharmacol. 2011 Apr;31(2):214-20
pubmed: 21346608
Psychopharmacol Bull. 2011 May 15;44(2):54-72
pubmed: 27738355
Endocr Rev. 2018 Aug 1;39(4):440-488
pubmed: 29684108
J Clin Psychiatry. 2015 Dec;76(12):e1574-82
pubmed: 26717533
Schizophr Res. 2018 Nov;201:432-434
pubmed: 29935888
Am J Psychiatry. 2001 Nov;158(11):1774-82
pubmed: 11691681
Cancer Epidemiol Biomarkers Prev. 2020 Jan;29(1):254-256
pubmed: 31685559
Int Clin Psychopharmacol. 2011 May;26(3):130-40
pubmed: 21191308
Eur Psychiatry. 2010 Jun;25 Suppl 2:S6-11
pubmed: 20620888
J Sex Med. 2010 Oct;7(10):3404-13
pubmed: 20214720
J Clin Psychiatry. 2009 Jun;70(6):829-36
pubmed: 19497249
Psychopharmacology (Berl). 1998 Nov;140(2):173-84
pubmed: 9860108
JAMA. 1995 Feb 8;273(6):461-5
pubmed: 7654270
J Psychopharmacol. 2018 Oct;32(10):1098-1103
pubmed: 29938561
J Psychiatr Res. 2007 Dec;41(11):895-905
pubmed: 17631314
Arch Gen Psychiatry. 1997 Jun;54(6):549-57
pubmed: 9193196
JAMA Psychiatry. 2016 Feb;73(2):121-8
pubmed: 26747088
Int Clin Psychopharmacol. 2016 Mar;31(2):61-8
pubmed: 26655732
F1000Res. 2018 Jan 9;7:30
pubmed: 31143439
J Clin Psychiatry. 2010 May;71(5):587-98
pubmed: 20492853
Epidemiology. 2021 Nov 1;32(6):846-854
pubmed: 34432720
Schizophr Res. 2016 Apr;172(1-3):152-7
pubmed: 26922656
BMC Med Res Methodol. 2018 Sep 24;18(1):96
pubmed: 30249204
Nature. 2018 Nov;563(7733):619-621
pubmed: 30482931
J Clin Psychiatry. 2012 Sep;73(9):e1168-74
pubmed: 23059159
Neuropsychopharmacology. 2019 Oct;44(11):1948-1954
pubmed: 31315130
Nat Med. 2007 Sep;13(9):1102-7
pubmed: 17767166
J Clin Psychiatry. 2002 Sep;63(9):763-71
pubmed: 12363115
Acta Psychiatr Scand. 2017 Jun;135(6):606-611
pubmed: 28407229
J Psychiatr Res. 2013 May;47(5):670-7
pubmed: 23421963
Schizophr Res. 2015 May;164(1-3):127-35
pubmed: 25682550
Cochrane Database Syst Rev. 2012 May 16;(5):CD008016
pubmed: 22592725
Int J Clin Pharm. 2017 Feb;39(1):16-25
pubmed: 28012118
Biol Psychiatry. 2016 Jun 15;79(12):952-61
pubmed: 26444072
Breast Cancer Res. 2018 May 19;20(1):42
pubmed: 29778097
Psychiatry Res. 2015 Jan 30;225(1-2):14-30
pubmed: 25466227
J Clin Psychopharmacol. 2014 Apr;34(2):199-204
pubmed: 24525659
J Clin Psychopharmacol. 2015 Aug;35(4):367-73
pubmed: 26075487
JAMA Psychiatry. 2019 Oct 1;76(10):1063-1073
pubmed: 31158853
Psychopharmacol Bull. 2010;43(4):37-69
pubmed: 21240151
Am J Psychiatry. 2011 Sep;168(9):957-67
pubmed: 21676992
J Clin Psychiatry. 2005;66 Suppl 6:5-10
pubmed: 16107178
JAMA Psychiatry. 2020 Feb 1;77(2):217-218
pubmed: 31693074
Eur Arch Psychiatry Clin Neurosci. 2018 Jun;268(4):383-390
pubmed: 29429138
PLoS One. 2020 Aug 27;15(8):e0237950
pubmed: 32853222
Nord J Psychiatry. 2008;62(5):342-5
pubmed: 18752109
J Psychiatr Res. 2009 Mar;43(6):620-6
pubmed: 19110264
Stat Med. 2016 Mar 30;35(7):966-77
pubmed: 26415869
Biol Psychiatry. 2007 Dec 15;62(12):1363-70
pubmed: 17601495
Eur Neuropsychopharmacol. 2014 Jul;24(7):1024-36
pubmed: 24735806
Schizophr Res. 2018 Nov;201:287-293
pubmed: 29706449
Psychopharmacology (Berl). 2013 Feb;225(3):519-30
pubmed: 22903391
Schizophr Res. 2018 Sep;199:2-16
pubmed: 29510928
Schizophr Res. 2016 Jul;174(1-3):93-98
pubmed: 27188270
Ann Intern Med. 2015 Jun 2;162(11):777-84
pubmed: 26030634
Psychopharmacology (Berl). 2016 Jul;233(14):2663-74
pubmed: 27271087
Ther Adv Psychopharmacol. 2015 Dec;5(6):322-31
pubmed: 26834965
J Clin Psychopharmacol. 2007 Dec;27(6):639-61
pubmed: 18004132
J Clin Psychopharmacol. 1996 Apr;16(2):158-69
pubmed: 8690831
Neurosci Biobehav Rev. 2021 May;124:54-62
pubmed: 33482243
Neuropsychopharmacology. 2019 Apr;44(5):915-922
pubmed: 30679724
Schizophr Res. 2014 Feb;152(2-3):450-7
pubmed: 24412468
Eur Neuropsychopharmacol. 2012 Oct;22(10):721-33
pubmed: 22464973
Clin Pharmacol Ther. 1970 Sep-Oct;11(5):680-8
pubmed: 4917090
Acta Psychiatr Scand. 2018 Oct;138(4):279-280
pubmed: 30240545
J Clin Psychiatry. 2016 Dec;77(12):1672-1680
pubmed: 27454547
Psychopharmacol Bull. 1992;28(2):213-8
pubmed: 1381102
Neuropsychopharmacology. 1996 Feb;14(2):111-23
pubmed: 8822534
J Clin Psychopharmacol. 2010 Apr;30(2):106-15
pubmed: 20520283
Transl Psychiatry. 2012 Nov 20;2:e189
pubmed: 23168989
Biol Psychiatry. 1997 Aug 15;42(4):233-46
pubmed: 9270900
CNS Drugs. 2009;23(7):615-25
pubmed: 19552488
Dis Nerv Syst. 1972 Dec;33(12):783-91
pubmed: 4589978
J Clin Psychopharmacol. 2010 Oct;30(5):487-95
pubmed: 20814330
J Clin Psychopharmacol. 2008 Apr;28(2 Suppl 1):S4-11
pubmed: 18334911
Psychopharmacology (Berl). 1996 Mar;124(1-2):159-67
pubmed: 8935812
Eur Psychiatry. 2004 Nov;19(7):415-22
pubmed: 15504648
Clin Psychol Rev. 2017 Feb;51:75-95
pubmed: 27838461
Am J Psychiatry. 2004 Jun;161(6):975-84
pubmed: 15169685
Ann Clin Biochem. 2010 Jul;47(Pt 4):292-300
pubmed: 20592331
PLoS One. 2020 Nov 11;15(11):e0241497
pubmed: 33175895
CNS Spectr. 2017 Aug;22(4):333-341
pubmed: 27821210
Psychiatry Res Neuroimaging. 2018 Sep 30;279:40-50
pubmed: 29861197
Am Health Drug Benefits. 2011 Sep;4(5):292-302
pubmed: 25126357
Am J Psychiatry. 1997 Jun;154(6):782-91
pubmed: 9167505
Neuropsychopharmacology. 1999 May;20(5):491-505
pubmed: 10192829
N Engl J Med. 2002 Aug 1;347(5):305-13
pubmed: 12151467
Endocr Rev. 2001 Dec;22(6):724-63
pubmed: 11739329
N Engl J Med. 2009 Jan 15;360(3):225-35
pubmed: 19144938
J Clin Psychiatry. 2007 Oct;68(10):1492-500
pubmed: 17960962
Psychopharmacology (Berl). 2008 Oct;200(3):317-31
pubmed: 18597078
Lancet. 2019 Sep 14;394(10202):939-951
pubmed: 31303314
CNS Drugs. 2011 Jun 1;25(6):473-90
pubmed: 21649448
Acta Psychiatr Scand. 2000 Mar;101(3):218-25
pubmed: 10721870
BMJ Open. 2019 Dec 23;9(12):e034816
pubmed: 31874900
Psychiatry Res. 2016 May 30;239:92-8
pubmed: 27137967
Lancet Psychiatry. 2020 Jan;7(1):64-77
pubmed: 31860457
Schizophr Res. 2007 Jul;93(1-3):117-30
pubmed: 17466492
J Psychopharmacol. 2010 Jul;24(7):1011-8
pubmed: 19825908
J Psychopharmacol. 2016 Aug;30(8):717-48
pubmed: 27147592
Am J Psychiatry. 2020 Mar 1;177(3):273-274
pubmed: 32114782
Psychiatry Clin Neurosci. 2018 Sep;72(9):692-700
pubmed: 29774628
Am J Psychiatry. 2015 Sep 1;172(9):870-80
pubmed: 25882325
J Clin Psychiatry. 2007 Jun;68(6):832-42
pubmed: 17592906
Psychopharmacol Bull. 2008;41(3):11-35
pubmed: 18779774
J Clin Psychopharmacol. 2011 Jun;31(3):349-55
pubmed: 21508856
Schizophr Res. 2007 Feb;90(1-3):147-61
pubmed: 17092691
J Psychiatr Res. 2014 Jun;53:14-22
pubmed: 24613032
Aust N Z J Psychiatry. 2011 Oct;45(10):830-7
pubmed: 21714721
World Psychiatry. 2013 Oct;12(3):216-26
pubmed: 24096780