Meta-analysis of clozapine and somnolence in schizophrenia.

IF 5.5 3区医学 Q1 CLINICAL NEUROLOGY

Journal of Psychopharmacology Pub Date : 2025-09-17 DOI:10.1177/02698811251364385

Matthew R Hopkins, Brian J Miller

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Abstract

Background: Clozapine has anti-suicidal properties and significant effects on sleep. Sleep disturbances are associated with suicide risk. Daytime somnolence and sedation are commonly reported adverse effects of clozapine treatment.

Aims: Systematic review and meta-analysis of somnolence in randomized controlled trials (RCTs) of patients with schizophrenia treated with clozapine.

Methods: We systematically searched PubMed, PsycINFO, and Web of Science databases. We included RCTs, in English, with data on somnolence in patients with schizophrenia treated with clozapine versus other antipsychotics. Data were pooled using a random effects model.

Results: Twenty-two RCTs (2991 patients: 1404 on clozapine and 1587 on other antipsychotics) met inclusion criteria. Patients treated with clozapine had a significantly increased odds of somnolence compared to other antipsychotics (36.3% vs 21.9%, OR = 2.06, 95% CI: 1.65-2.57, p < 0.01). Clozapine was also associated with significantly increased odds of somnolence compared to olanzapine and risperidone. In meta-regression analyses, clozapine dose, age, sex, race, and publication year were unrelated to the association.

Conclusions: Clozapine is associated with significantly more somnolence, compared to other antipsychotics. A greater mechanistic understanding of associations between sleep changes and suicide risk in patients treated with clozapine is needed.

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氯氮平与精神分裂症嗜睡的meta分析。

背景：氯氮平具有抗自杀特性，对睡眠有显著影响。睡眠障碍与自杀风险有关。白天嗜睡和镇静是氯氮平治疗的常见不良反应。目的：对氯氮平治疗的精神分裂症患者嗜睡的随机对照试验（rct）进行系统评价和荟萃分析。方法：系统检索PubMed、PsycINFO和Web of Science数据库。我们纳入了英文随机对照试验，其中包含氯氮平与其他抗精神病药物治疗的精神分裂症患者嗜睡的数据。数据采用随机效应模型汇总。结果：22项随机对照试验（2991例患者，氯氮平组1404例，其他抗精神病药物组1587例）符合纳入标准。与其他抗精神病药物相比，氯氮平治疗的患者嗜睡的几率明显增加（36.3% vs 21.9%, OR = 2.06, 95% CI: 1.65-2.57, p）。结论：与其他抗精神病药物相比，氯氮平与嗜睡的发生率明显增加。需要对氯氮平治疗患者的睡眠改变和自杀风险之间的联系进行更深入的机制理解。

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

Journal of Psychopharmacology 医学-精神病学

CiteScore

8.60

自引率

4.90%

发文量

126

审稿时长

3-8 weeks

期刊介绍： The Journal of Psychopharmacology is a fully peer-reviewed, international journal that publishes original research and review articles on preclinical and clinical aspects of psychopharmacology. The journal provides an essential forum for researchers and practicing clinicians on the effects of drugs on animal and human behavior, and the mechanisms underlying these effects. The Journal of Psychopharmacology is truly international in scope and readership.