Adjunctive ondansetron for schizophrenia: A systematic review and meta-analysis of randomized controlled trials
Zheng,Wei1; Cai,Dong Bin2; Zhang,Qing E.3; He,Jie4; Zhong,Li Yun5; Sim,Kang6; Ungvari,Gabor S.7,8; Ning,Yu Ping1; Xiang,Yu Tao9
Source PublicationJournal of Psychiatric Research
AbstractThe serotonin 5-hydroxytryptamine type 3 (5-HT3) receptor has been implicated in the pathogenesis of schizophrenia. This meta-analysis of randomized controlled trials (RCTs) examined the efficacy and safety of adjunctive ondansetron, a potent 5-HT3 receptor antagonist, in the treatment of schizophrenia. Only RCTs examining adjunctive ondansetron for schizophrenia were included. Standardized mean difference (SMD), risk ratio (RR) and their 95% confidence intervals (CIs) were analyzed using RevMan, Version 5.3. Study quality was evaluated with the Cochrane risk of bias and the Jadad scale. Data of 5 RCTs (n = 304) covering 149 patients on ondansetron (4-8 mg/day) and 155 patients on placebo were analyzed. Three RCTs reported “randomized allocation” with a specific description; the weighted Jadad score was 3.8. Adjunctive ondansetron outperformed placebo in the reduction of Positive and Negative Syndrome Scale (PANSS) total score [3 RCTs, n = 171; SMD: −1.06 (95%CI: −2.10, −0.02), p = 0.04, I = 85%], the negative [4 RCTs, n = 209; SMD: −0.96 (95%CI: −1.71, −0.22), p = 0.01, I = 80%], and general psychopathology symptom scores [3 RCTs, n = 171; SMD: −0.97 (95%CI: −1.91, −0.02), p = 0.04, I = 82%], but not in the positive (p = 0.05) and depressive symptom scores (p = 0.91). The difference in PANSS total score remained significant after excluding one outlying RCT [2 RCTs, n = 141; SMD: −0.50 (95%CI: −0.84, −0.16), P = 0.004, I = 0%]. Four RCTs examined the effect of ondansetron on cognition applying different instruments yielding conflicting findings. Ondansetron was superior over placebo in improving extrapyramidal symptoms, but no group differences were found in overall discontinuation rate and adverse drug reactions. In conclusion, adjunctive ondansetron appears to be efficacious and safe in improving negative symptoms and general psychopathology. The effect of ondansetron on cognitive impairment in schizophrenia needs to be further explored in large-scale RCTs.
KeywordCognition Meta-analysis Negative symptoms Ondansetron Schizophrenia
URLView the original
Scopus ID2-s2.0-85063323407
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Cited Times [WOS]:10   [WOS Record]     [Related Records in WOS]
Document TypeJournal article
CollectionUniversity of Macau
Affiliation1.The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital),Guangzhou,China
2.Shenzhen Traditional Chinese Medicine Hospital,Shenzhen,China
3.The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders,Beijing Anding Hospital,Capital Medical University & the Advanced Innovation Center for Human Brain Protection,Capital Medical University,Beijing,China
4.The Third Affiliated Hospital of Sun Yat-sen University,Guangzhou,China
5.Houjie Hospital of Dongguan City,Dongguan,China
6.Institute of Mental Health,Buangkok Green Medical Park,Singapore
7.The University of Notre Dame Australia,Fremantle,Australia
8.Division of Psychiatry,School of Medicine,University of Western Australia,Perth,Australia
9.Unit of Psychiatry,Institute of Translational Medicine,Faculty of Health Sciences,University of Macau,China
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GB/T 7714
Zheng,Wei,Cai,Dong Bin,Zhang,Qing E.,et al. Adjunctive ondansetron for schizophrenia: A systematic review and meta-analysis of randomized controlled trials[J]. Journal of Psychiatric Research,2019,113:27-33.
APA Zheng,Wei,Cai,Dong Bin,Zhang,Qing E.,He,Jie,Zhong,Li Yun,Sim,Kang,Ungvari,Gabor S.,Ning,Yu Ping,&Xiang,Yu Tao.(2019).Adjunctive ondansetron for schizophrenia: A systematic review and meta-analysis of randomized controlled trials.Journal of Psychiatric Research,113,27-33.
MLA Zheng,Wei,et al."Adjunctive ondansetron for schizophrenia: A systematic review and meta-analysis of randomized controlled trials".Journal of Psychiatric Research 113(2019):27-33.
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