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Nutraceuticals and phytoceuticals in the treatment of schizophrenia: a systematic review and network meta-analysis “Nutra NMA SCZ”
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- Fornaro, Michele (författare)
- Univ Sch Med Federico II, Italy
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- Caiazza, Claudio (författare)
- Univ Sch Med Federico II, Italy
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- Billeci, Martina (författare)
- Univ Sch Med Federico II, Italy
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- Berk, Michael (författare)
- Deakin Univ, Australia; Barwon Hlth, Australia; Orygen, Australia; Florey Inst Neurosci & Mental Hlth, Australia; Univ Melbourne, Australia
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- Marx, Wolfgang (författare)
- Deakin Univ, Australia
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- Balanza-Martinez, Vicent (författare)
- Univ Valencia, Spain
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- De Prisco, Michele (författare)
- Univ Barcelona, Spain
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- Pezone, Rosanna (författare)
- Univ Sch Med Federico II, Italy
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- De Simone, Giuseppe (författare)
- Univ Sch Med Federico II, Italy
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- Solini, Niccolo (författare)
- Univ Sch Med Federico II, Italy
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- Iasevoli, Felice (författare)
- Univ Sch Med Federico II, Italy; Univ Med Sch Naples Federico II, Italy
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- Berna, Fabrice (författare)
- Univ Strasbourg, France
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- Fond, Guillaume (författare)
- Aix Marseille Univ, France; Univ Paris Est, France
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- Boyer, Laurent (författare)
- Aix Marseille Univ, France; Univ Paris Est, France
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- Carvalho, Andre Ferrer (författare)
- Deakin Univ, Australia
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- Dragioti, Elena (författare)
- Linköpings universitet,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten,Region Östergötland, Smärt och rehabiliteringscentrum
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- Fiedorowicz, Jess G. (författare)
- Univ Ottawa, Canada; Ottawa Hosp, Canada
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- de Bartolomeis, Andrea (författare)
- Univ Sch Med Federico II, Italy; Univ Med Sch Naples Federico II, Italy
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- Correll, Christoph U. (författare)
- Northwell Hlth, NY USA; Zucker Sch Med Hofstra Northwell, NY USA; Feinstein Inst Med Res, NY USA; Charite, Germany
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- Solmi, Marco (författare)
- Univ Ottawa, Canada; Ottawa Hosp, Canada; Charite, Germany
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(creator_code:org_t)
- 2024
- 2024
- Engelska.
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Ingår i: Molecular Psychiatry. - : SPRINGERNATURE. - 1359-4184 .- 1476-5578.
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Sub-optimal response in schizophrenia is frequent, warranting augmentation strategies over treatment-as-usual (TAU). We assessed nutraceuticals/phytoceutical augmentation strategies via network meta-analysis. Randomized controlled trials in schizophrenia/schizoaffective disorder were identified via the following databases: PubMed, MEDLINE, EMBASE, Scopus, PsycINFO, CENTRAL, and ClinicalTrials.gov. Change (Standardized Mean Difference = SMD) in total symptomatology and acceptability (Risk Ratio = RR) were co-primary outcomes. Secondary outcomes were positive, negative, cognitive, and depressive symptom changes, general psychopathology, tolerability, and response rates. We conducted subset analyses by disease phase and sensitivity analyses by risk of bias and assessed global/local inconsistency, publication bias, risk of bias, and confidence in the evidence. The systematic review included 49 records documenting 50 studies (n = 2384) documenting 22 interventions. Citicoline (SMD =-1.05,95%CI = -1.85; -0.24), L-lysine (SMD = -1.04,95%CI = -1.84; -0.25), N-acetylcysteine (SMD = -0.87, 95%CI = -1.27; -0.47) and sarcosine (SMD = -0.5,95%CI = -0.87-0.13) outperformed placebo for total symptomatology. High heterogeneity (tau2 = 0.10, I-2 = 55.9%) and global inconsistency (Q = 40.79, df = 18, p = 0.002) emerged without publication bias (Egger's test, p = 0.42). Sarcosine improved negative symptoms (SMD = -0.65, 95%CI = -1.10; -0.19). N-acetylcysteine improved negative symptoms (SMD = -0.90, 95%CI = -1.42; -0.39)/general psychopathology (SMD = -0.76, 95%CI = -1.39; -0.13). No compound improved total symptomatology within acute phase studies (k = 7, n = 422). Sarcosine (SMD = -1.26,95%CI = -1.91; -0.60), citicoline (SMD = -1.05,95%CI = -1.65;-0.44), and N-acetylcysteine (SMD = -0.55,95%CI = -0.92,-0.19) outperformed placebo augmentation in clinically stable participants. Sensitivity analyses removing high-risk-of-bias studies confirmed overall findings in all phases and clinically stable samples. In contrast, the acute phase analysis restricted to low risk-of-bias studies showed a superior effect vs. placebo for N-acetylcysteine (SMD = -1.10, 95%CI = -1.75,-0.45), L-lysine (SMD = -1.05,95%CI = -1.55, -0.19), omega-3 fatty acids (SMD = -0.83,95%CI = -1.31, -0.34) and withania somnifera (SMD = -0.71,95%CI = -1.21,-0.22). Citicoline (SMD = -1.05,95%CI = -1.86,-0.23), L-lysine (SMD = -1.04,95%CI = -1.84,-0.24), N-acetylcysteine (SMD = -0.89,95%CI = -1.35,-0.43) and sarcosine (SMD = -0.61,95%CI = -1.02,-0.21) outperformed placebo augmentation of TAU ("any phase"). Drop-out due to any cause or adverse events did not differ between nutraceutical/phytoceutical vs. placebo+TAU. Sarcosine, citicoline, and N-acetylcysteine are promising augmentation interventions in stable patients with schizophrenia, yet the quality of evidence is low to very low. Further high-quality trials in acute phases/specific outcomes/difficult-to-treat schizophrenia are warranted.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Psykiatri (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Psychiatry (hsv//eng)
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Fornaro, Michele
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Caiazza, Claudio
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Billeci, Martina
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Berk, Michael
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Marx, Wolfgang
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Balanza-Martinez ...
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De Prisco, Miche ...
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Pezone, Rosanna
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De Simone, Giuse ...
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Solini, Niccolo
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Iasevoli, Felice
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Berna, Fabrice
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Fond, Guillaume
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Boyer, Laurent
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Carvalho, Andre ...
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Dragioti, Elena
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Fiedorowicz, Jes ...
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de Bartolomeis, ...
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Correll, Christo ...
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Solmi, Marco
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