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Efficacy and Safety of Adjunctive Aripiprazole, Metformin, and Paeoniae–Glycyrrhiza Decoction for Antipsychotic-Induced Hyperprolactinemia: A Network Meta-Analysis of Randomized Controlled Trials
Zhang, Ling1; Qi, Han2; Xie, Yun Yi1; Zheng, Wei3; Liu, Xiao Hui1; Cai, Dong Bin4; Ng, Chee H.5; Ungvari, Gabor S.6,7; Xiang, Yu Tao8,9,10
2021-09-29
Source PublicationFrontiers in Psychiatry
ISSN1664-0640
Volume12Issue:728204
Abstract

Aripiprazole, metformin, and paeoniae–glycyrrhiza decoction (PGD) have been widely used as adjunctive treatments to reduce antipsychotic (AP)-induced hyperprolactinemia in patients with schizophrenia. However, the comparative efficacy and safety of these medications have not been previously studied. A network meta-analysis of randomized controlled trials (RCTs) was conducted to compare the efficacy and safety between aripiprazole, metformin, and PGD as adjunctive medications in reducing AP-induced hyperprolactinemia in schizophrenia. Both international (PubMed, PsycINFO, EMBASE, and Cochrane Library databases) and Chinese (WanFang, Chinese Biomedical, and Chinese National Knowledge infrastructure) databases were searched from their inception until January 3, 2019. Data were analyzed using the Bayesian Markov Chain Monte Carlo simulations with the WinBUGS software. A total of 62 RCTs with 5,550 participants were included in the meta-analysis. Of the nine groups of treatments included, adjunctive aripiprazole (<5 mg/day) was associated with the most significant reduction in prolactin levels compared to placebo (posterior MD = −65.52, 95% CI = −104.91, −24.08) and the other eight treatment groups. Moreover, adjunctive PGD (>1:1) was associated with the lowest rate of all-cause discontinuation compared to placebo (posterior odds ratio = 0.45, 95% CI = 0.10, 3.13) and adjunctive aripiprazole (>10 mg/day) was associated with fewer total adverse drug events than placebo (posterior OR = 0.93, 95% CI = 0.65, 1.77) and other eight treatment groups. In addition, when risperidone, amisulpride, and olanzapine were the primary AP medications, adjunctive paeoniae/glycyrrhiza = 1:1, aripiprazole <5 mg/day, and aripiprazole >10 mg/day were the most effective treatments in reducing the prolactin levels, respectively. Adjunctive aripiprazole, metformin, and PGD showed beneficial effects in reducing AP-induced hyperprolactinemia in schizophrenia, with aripiprazole (<5 mg/day) being the most effective one.

KeywordAripiprazole Metformin Paeoniae–glycyrrhiza Decoction Hyperprolactinemia Network Meta-analysis
DOI10.3389/fpsyt.2021.728204
URLView the original
Indexed BySCIE ; SSCI
Language英語English
WOS Research AreaPsychiatry
WOS SubjectPsychiatry
WOS IDWOS:000717183200001
PublisherFRONTIERS MEDIA SA, AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE CH-1015, SWITZERLAND
Scopus ID2-s2.0-85117143506
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Citation statistics
Document TypeJournal article
CollectionInstitute of Translational Medicine
INSTITUTE OF COLLABORATIVE INNOVATION
INSTITUTE OF ADVANCED STUDIES IN HUMANITIES AND SOCIAL SCIENCES
DEPARTMENT OF PUBLIC HEALTH AND MEDICINAL ADMINISTRATION
Co-First AuthorZhang, Ling; Qi, Han; Xie, Yun Yi; Zheng, Wei; Liu, Xiao Hui
Corresponding AuthorZhang, Ling; Xiang, Yu Tao
Affiliation1.Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
2.The National Clinical Research Center for Mental Disorders Beijing Key Laboratory of Mental Disorders, The Advanced Innovation Center for Human Brain Protection, School of Mental Health, Beijing Anding Hospital, Capital Medical University, Beijing, China
3.The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
4.Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
5.Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Australia
6.Division of Psychiatry, School of Medicine, University of Western Australia/Graylands Hospital, Perth, Australia
7.Section of Psychiatry, University of Notre Dame Australia, Fremantle, Australia
8.Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao
9.Centre for Cognitive and Brain Sciences, University of Macau, Macao
10.Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao
Corresponding Author AffilicationFaculty of Health Sciences;  University of Macau
Recommended Citation
GB/T 7714
Zhang, Ling,Qi, Han,Xie, Yun Yi,et al. Efficacy and Safety of Adjunctive Aripiprazole, Metformin, and Paeoniae–Glycyrrhiza Decoction for Antipsychotic-Induced Hyperprolactinemia: A Network Meta-Analysis of Randomized Controlled Trials[J]. Frontiers in Psychiatry, 2021, 12(728204).
APA Zhang, Ling., Qi, Han., Xie, Yun Yi., Zheng, Wei., Liu, Xiao Hui., Cai, Dong Bin., Ng, Chee H.., Ungvari, Gabor S.., & Xiang, Yu Tao (2021). Efficacy and Safety of Adjunctive Aripiprazole, Metformin, and Paeoniae–Glycyrrhiza Decoction for Antipsychotic-Induced Hyperprolactinemia: A Network Meta-Analysis of Randomized Controlled Trials. Frontiers in Psychiatry, 12(728204).
MLA Zhang, Ling,et al."Efficacy and Safety of Adjunctive Aripiprazole, Metformin, and Paeoniae–Glycyrrhiza Decoction for Antipsychotic-Induced Hyperprolactinemia: A Network Meta-Analysis of Randomized Controlled Trials".Frontiers in Psychiatry 12.728204(2021).
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