Pharmacopsychiatry 2020; 53(01): 5-13
DOI: 10.1055/a-0914-3260
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

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

Wei Zheng*
1  The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
,
Xian-Bin Li*
2  The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
,
Zhan-Ming Shi*
3  Chongqing Jiangbei Mental Health Center, Chongqing, China
,
Xin-Hu Yang
1  The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
,
Dong-Bin Cai
4  Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
,
Chee H. Ng
5  Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
,
Gabor S. Ungvari
6  The University of Notre Dame Australia, Fremantle, Australia
7  Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
,
Wei-Jian Liu
1  The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
,
Yu-Jie Wu
1  The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
,
Yuan-Yuan Wang
8  Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
,
Yu-Ping Ning
1  The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
,
Yu-Tao Xiang
9  Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
› Author Affiliations
Role of the Funding Source The study was supported by the University of Macau (SRG2014–00019-FHS; MYRG2015–00230-FHS; MYRG2016–00005-FHS), the National Natural Science Foundation of China (81601169), the Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (ZYLX201807, XLMX201807), Capital’s Funds for Health Improvement and Research (2018-2-2123), and the Major Science and Technology Award of the Science and Technology Department of Guangdong Province (2016B010108003).
Further Information

Publication History

received 02 April 2018
revised 25 April 2019

accepted 29 April 2019

Publication Date:
17 June 2019 (online)

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.

* These authors contributed equally to the paper.


Supplementary information