The efficacy and safety of sodium nitroprusside in the treatment of schizophrenia: a meta-analysis

Xinxing Fei; Jiyang Li; Shiqi Wang; Jianxiong Wang; Changmei Guo; Rizhi Qisha; Yaqian Gao; Yue Hu

doi:10.3389/fpsyt.2023.1271624

The efficacy and safety of sodium nitroprusside in the treatment of schizophrenia: a meta-analysis

Front Psychiatry. 2023 Nov 6:14:1271624. doi: 10.3389/fpsyt.2023.1271624. eCollection 2023.

Authors

Xinxing Fei^#¹, Jiyang Li^#², Shiqi Wang^#^{3

4}, Jianxiong Wang⁵, Changmei Guo⁵, Rizhi Qisha⁵, Yaqian Gao⁶, Yue Hu⁵

Affiliations

¹ Department of Psychiatry, Chengdu Eighth People's Hospital (Geriatric Hospital of Chengdu Medical College), Chengdu, Sichuan, China.
² Department of Rehabilitation Medicine, Sichuan Tianfu New Area People's Hospital, Chengdu, Sichuan, China.
³ Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.
⁴ Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, China.
⁵ Department of Rehabilitation Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
⁶ Department of Rehabilitation Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China.

^# Contributed equally.

Abstract

Objective: Schizophrenia is a serious mental disease that brings not only serious burdens to patients and their families but also serious challenges to society. More research is needed to find better drugs to treat schizophrenia. This meta-analysis investigated the efficacy and safety of sodium nitroprusside in the treatment of schizophrenia.

Methods: Randomized controlled trials comparing the efficacy and safety of sodium nitroprusside in the treatment of schizophrenia were searched via English and Chinese databases. The outcomes, including the Positive and Negative Syndrome Scale (PANSS) and Brief Psychiatric Rating Scale (BPRS), were recorded. RevMan 5.3 was used for the meta-analysis.

Results: A total of six randomized controlled trials (174 patients) were included. The overall quality of the included studies was good. No statistically significant benefit of sodium nitroprusside over placebo was found when combined PANSS total and BPRS-18 (95% CI: -1.40, 0.02). Except for PANSS positive (95% CI: -1.86, -0.01), there was no significant difference in the scale score after sodium nitroprusside treatment compared with the control group in PANSS total (95% CI: -4.93, 0.23), PANSS general (95% CI: -2.53, 1.33), and PANSS negative (95% CI: -4.44, 0.89). The results of the sensitivity analysis excluding the study with clinical heterogeneity showed that sodium nitroprusside had no statistical benefit for the score of PANSS positive (95% CI: -2.19, 0.46). Moreover, there was also no significant difference in the BPRS-18 (95% CI: -3.23, -0.43).

Conclusion: We conservatively believe that sodium nitroprusside does not alleviate the symptoms of schizophrenia compared with placebo. The subjects tolerated sodium nitroprusside well. Our findings provide a new idea for researchers to explore and solve the drug treatment of schizophrenia.

Keywords: Brief Psychiatric Rating Scale; Positive and Negative Syndrome Scale; meta-analysis; schizophrenia; sodium nitroprusside.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was funded by Innovative Entrepreneurship training Program for College students of Southwest Medical University (grant number S2022106 32190 and S2022106 32209).