Back to Search
Start Over
Folic acid/methylfolate for the treatment of psychopathology in schizophrenia: a systematic review and meta-analysis.
- Source :
-
Psychopharmacology [Psychopharmacology (Berl)] 2018 Aug; Vol. 235 (8), pp. 2303-2314. Date of Electronic Publication: 2018 May 22. - Publication Year :
- 2018
-
Abstract
- Rationale: This study aims to examine whether folate/folic acid/methylfolate/folinic acid supplemented to antipsychotics (FA + AP) is beneficial in schizophrenia treatment.<br />Objective: We conducted a comprehensive systematic review and meta-analysis of double-blind, placebo-controlled, randomized clinical trials (RCTs) of FA + AP for schizophrenia.<br />Methods: The primary outcome was an improvement in total symptoms. Other outcomes were psychopathology subscales (positive, negative, general, and depressive symptoms), discontinuation due to all-cause and adverse events, and individual adverse events. The meta-analysis evaluated the effect size based on a random-effects model.<br />Results: Although we included ten RCTs with 925 patients in total (seven folic acid RCTs (n = 789), two methylfolate RCTs (n = 96), and one folinic acid RCT (n = 40)) in the systematic review, only seven RCTs were included in the meta-analysis. Pooled FA + AP treatments were not superior to placebo + AP in the improvement of total (N = 7, n = 340; standardized mean difference (SMD) = - 0.20, 95% confidence interval (CI) = - 0.41, 0.02, p = 0.08, I <superscript>2</superscript>  = 0%), positive, general, or depressive symptoms. Pooled FA + AP treatments were more effective than placebo + AP for negative symptoms (N = 5, n = 281; SMD = -0.25, 95% CI = -0.49, -0.01, p = 0.04, I <superscript>2</superscript>  = 0%). Although pooled FA + AP treatments were associated with a lower incidence of serious adverse events than placebo treatments (N = 4, n = 241; risk ratio = 0.32, 95% CI = 0.12-0.82, p = 0.02, I <superscript>2</superscript>  = 0%; number needed to harm = not significant), there were no significant differences in other safety outcomes between both treatments.<br />Conclusions: Our findings suggest that pooled FA + AP treatment improves negative symptoms in schizophrenia patients. Moreover, this treatment was well tolerated. However, because our results might exhibit a small-study effect, future studies with a larger sample should be conducted to obtain more robust results.
- Subjects :
- Depression epidemiology
Depression psychology
Double-Blind Method
Drug Therapy, Combination
Humans
Psychopathology
Randomized Controlled Trials as Topic methods
Schizophrenia epidemiology
Treatment Outcome
Antipsychotic Agents administration & dosage
Depression drug therapy
Folic Acid administration & dosage
Schizophrenia drug therapy
Schizophrenic Psychology
Tetrahydrofolates administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1432-2072
- Volume :
- 235
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Psychopharmacology
- Publication Type :
- Academic Journal
- Accession number :
- 29785555
- Full Text :
- https://doi.org/10.1007/s00213-018-4926-4