Response efficacy and heterogeneity of antipsychotic drugs in schizophrenia: Systemic review and meta-analysis

Abstract

Backgrounds: This meta-analysis aimed to assess antipsychotic and placebo effects in patients with schizophrenia at the level of symptom factors.

Methods: A systematic literature search up to June 2020 was undertaken and 62 studies were included, with 23,478 patients with schizophrenia at the study baseline point. We calculated mean differences with 95% confidence intervals. The comparison was made according to the study content using a continuous method with a random-effects model.

Results: Patients with schizophrenia treated by antipsychotic drugs had a significantly lower psychiatric rating scale total score; lower clinical global impression of severity; lower positive and negative syndrome scale; and lower assessment of negative symptoms total score, when compared to placebo treated patients.

Conclusions: Patients with schizophrenia treated with an antipsychotic drug show a much greater improvement and lower inconsistency in the level of symptom factors when compared to the effects of placebo. Our findings evidence for a comparatively homogeneous outcome of the antipsychotic-treatment in improving schizophrenia symptoms. This opposes the notion of the presence of patient sub-groups with treatment non-responsive schizophrenia.

Keywords: antipsychotic; psychiatric rating scale total score; schizophrenia; the clinical global impression of severity.