Efficacy, Tolerability, and Safety of Blonanserin in Schizophrenia: An Updated and Extended Systematic Review and Meta-Analysis of Randomized Controlled Trials

Pharmacopsychiatry. 2019 Feb;52(2):52-62. doi: 10.1055/a-0574-0088. Epub 2018 Mar 7.

Abstract

Introduction: We conducted an updated systematic review and meta-analysis of randomized controlled trials (RCTs) comparing blonanserin with other antipsychotics (amisulpride, aripiprazole, haloperidol, paliperidone, and risperidone).

Methods: Weighted mean difference (WMD), risk ratio, and number needed to harm (NNH) with 95% confidence intervals (95% CIs) were calculated using random-effects model.

Results: Ten RCTs (n=1521) were included in this study. Blonanserin was superior to aripiprazole in improvement of Positive and Negative Syndrome Scale total scores (WMD=-10.62, 95% CI=-17.67 to -3.560, p=0.003). Blonanserin was associated with a higher incidence of all-cause discontinuation (RR=1.373, 95% CI=1.088-1.734, p=0.008, NNH=11), akathisia, extrapyramidal disorder, and agitation/excitement and a lower risk of hyperprolactinemia compared with risperidone + paliperidone.

Discussion: The current meta-analytic study did not update the comparison of blonanserin vs. haloperidol because there were no new RCTs. Our results suggest that the efficacy of blonanserin for schizophrenia is comparable with that of other antipsychotics, and blonanserin seems to be well tolerated.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Antipsychotic Agents / pharmacology
  • Antipsychotic Agents / therapeutic use*
  • Humans
  • Piperazines / pharmacology
  • Piperazines / therapeutic use*
  • Piperidines / pharmacology
  • Piperidines / therapeutic use*
  • Randomized Controlled Trials as Topic / methods*
  • Schizophrenia / drug therapy*

Substances

  • Antipsychotic Agents
  • Piperazines
  • Piperidines
  • blonanserin