Efficacy and safety of ondansetron in schizophrenia: A systematic review and meta-analysis of randomized controlled trials

IF 3.7 2区医学 Q1 PSYCHIATRY

General hospital psychiatry Pub Date : 2025-06-04 DOI:10.1016/j.genhosppsych.2025.06.001

Omar Kassar , Omar Shaheen , Abdullah Selim , Mahmoud Soliman , Lamees Taman , Ahmed Elshahat , Moaz Elsayed Abouelmagd

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引用次数: 0

Abstract

Purpose

It has been shown that 5-hydroxytryptamine3 (5-HT3) receptors are involved in the pathogenesis of schizophrenia. This systematic review and meta-analysis of randomized clinical trials (RCTs) evaluates the efficacy and safety of ondansetron, a potent 5-HT3 receptor antagonist, as adjunctive treatment for the management of schizophrenia, especially the negative symptoms.

Methods

A comprehensive search of electronic databases, including PubMed, Scopus, Cochrane, and Web of Science, was performed in October 2024. We included only randomized controlled trials (RCTs), and their data were extracted and analyzed using RevMan 5.4 software. The primary outcome was the PANSS (Positive and Negative Syndrome Scale) negative subscale.

Results

Eight RCTs involving 533 patients were included in the study. Ondansetron showed a statistically significant improvement in PANSS negative subscale at 12 weeks [pooled as mean difference, MD = −2.96, 95 % CI [−4.69, −1.24], P-value = 0.00007] and in general psychopathology scale [MD = −2.71, 95 % CI [−3.52, −1.90] compared to placebo. However, ondansetron and placebo did not differ in reduction of PANSS positive subscale [MD = 0.1, 95 % CI [−1.19, 1.38], P-value = 0.88], and depression scale. Ondansetron showed no significant difference regarding tardive dyskinesia between the two groups. However, constipation was significant in the ondansetron group over placebo.

Conclusion

The study findings provide valuable insights into the efficacy of ondansetron, a serotonin receptor antagonist, in managing schizophrenia, particularly negative symptoms. However, the limitations of the study highlight the need for caution in interpreting these results. Further high-quality trials are required to confirm our findings and explore the long-term impact of ondansetron in the treatment of schizophrenia.

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昂丹司琼治疗精神分裂症的疗效和安全性：随机对照试验的系统回顾和荟萃分析

目的5-羟色胺3 （5-HT3）受体参与了精神分裂症的发病机制。本系统综述和随机临床试验（rct）的荟萃分析评估了昂丹司琼（一种有效的5-HT3受体拮抗剂）作为精神分裂症，特别是阴性症状治疗的辅助治疗的有效性和安全性。方法于2024年10月对PubMed、Scopus、Cochrane、Web of Science等电子数据库进行综合检索。我们只纳入随机对照试验（RCTs），并使用RevMan 5.4软件提取数据并进行分析。主要结果为PANSS（阳性和阴性综合征量表）阴性子量表。结果共纳入8项随机对照试验，共533例患者。与安慰剂相比，昂丹西琼在12周时的PANSS阴性亚量表（合并为平均差异，MD = - 2.96, 95% CI [- 4.69, - 1.24]， p值= 0.00007）和一般精神病理量表（MD = - 2.71, 95% CI[- 3.52, - 1.90]）上有统计学显著改善。然而，昂丹司琼和安慰剂在PANSS阳性亚量表（MD = 0.1, 95% CI [- 1.19, 1.38]， p值= 0.88）和抑郁量表的减少方面没有差异。昂丹司琼治疗两组迟发性运动障碍无显著差异。然而，便秘在昂丹司琼组明显优于安慰剂组。结论：该研究结果为血清素受体拮抗剂昂丹司琼治疗精神分裂症，特别是阴性症状的疗效提供了有价值的见解。然而，该研究的局限性强调了在解释这些结果时需要谨慎。需要进一步的高质量试验来证实我们的发现，并探索昂丹司琼治疗精神分裂症的长期影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

General hospital psychiatry 医学-精神病学

CiteScore

9.60

自引率

2.90%

发文量

125

审稿时长

20 days

期刊介绍： General Hospital Psychiatry explores the many linkages among psychiatry, medicine, and primary care. In emphasizing a biopsychosocial approach to illness and health, the journal provides a forum for professionals with clinical, academic, and research interests in psychiatry''s role in the mainstream of medicine.