Statin add-on therapy in the antipsychotic treatment of schizophrenia: A meta-analysis

Psychiatry Res. 2018 Feb:260:41-47. doi: 10.1016/j.psychres.2017.11.033. Epub 2017 Nov 11.

Abstract

A comprehensive meta-analysis of statin add-on therapy in the antipsychotic treatment of schizophrenia was conducted. Data from previous studies, prior to 8/21/2017, was obtained from Scopus, PubMed, PsycINFO, and Cochrane Library. Both a systematic review and meta-analysis were conducted with patient data from randomized placebo-controlled trials (RCTs) to compare statins with placebo in order to calculate effect size. Across the five RCTs (mean duration: 9.2 weeks), 236 adult patients with schizophrenia were randomly selected to receive either placebo (n=117) or statins (n=119). Pooled statin add-on therapy showed significant superiority over placebo in the improvement of Positive and Negative Syndrome Scale (PANSS) total scores (mean difference=-1.96; 95% confidence interval, -2.94 to -0.98; p<0.0001; I2=0%; N=4, n=174). However, there were no statistically significant differences in other efficacy outcomes between the two treatment groups. Statin did not have a significant difference in its incidence of discontinuation or have individual adverse events compared to placebo. Our results suggest that statins may have considerable potential as an add-on therapy for schizophrenia. However, determining the effectiveness of this treatment in clinical practice requires future investigation due to limitations of the current evidence-base including small sample, potential for publication and selection biases and short duration of follow-up.

Keywords: Efficacy; Meta-analysis; Safety; Schizophrenia; Statins; Systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Antipsychotic Agents / therapeutic use*
  • Drug Therapy, Combination
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Male
  • Randomized Controlled Trials as Topic
  • Schizophrenia / drug therapy*
  • Treatment Outcome
  • Young Adult

Substances

  • Antipsychotic Agents
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors