Psychiatry and Clinical Psychopharmacology
Original Article

Efficacy and acceptability of three prolactin-sparing antipsychotics in patient with schizophrenia: a network meta-analysis


Department of Psychiatry, Wenzhou Seventh People’s Hospital, Wenzhou, People’s Republic of China


Department of Psychiatry, Institute of Mental Healthy, Genetic Lab, Jining Medical University, Jining, People’s Republic of China


Department of Psychiatric-NeuroimagingGenetics and Comorbidity Laboratory(PNGC-lab), Tianjin Mental Health Canter, Tianjin Anding Hospital, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin, People’s Republic of China

Psychiatry and Clinical Psychopharmacology 2019; 29: 369-378
DOI: 10.1080/24750573.2019.1662629
Read: 900 Downloads: 619 Published: 08 February 2021

Background: The present study aimed to systematically evaluate three prolactin-sparing antipsychotics for treating schizophrenia.

Methods: We performed a meta-analysis of three prolactin-sparing antipsychotics in patients with schizophrenia. Endpoints of interest were the Positive and Negative Syndrome Scale (PANSS), Brief Psychiatric Rating Scale (BPRS), Clinical Global Impressions-Severity (CGI-S) and acceptability (all cause discontinuation).

Results: A total of 12 trials (2,723 patients) and three drugs (aripiprazole, quetiapine, and ziprasidone) were included. On the PANSS scale, aripiprazole (mean difference [MD]: −6.98, 95% CrI: −12.35, −1.38) was statistically more effective than placebo. When assessed by BPRS, aripiprazole (MD: −9.01, 95% CrI: −15.81, −3.12), quetiapine (MD: −7.13, 95% CrI: −9.78, −4.29) and ziprasidone (MD: −4.97, 95% CrI: 9.96, −0.21) had greater efficacy, when compared to placebo. Regarding CGI-S, quetiapine (MD: −0.55, 95% CrI: −0.82, −0.25) was significantly superior to placebo. In terms of acceptability, aripiprazole (OR: 0.54, 95% CrI: 0.41, 0.73), quetiapine (OR: 0.49, 95% CrI: 0.36, 0.68) and ziprasidone (OR: 0.68, 95% CrI: 0.48, 0.96) were more acceptable than placebo. The benefit risk analysis revealed that quetiapine has the best efficacy and acceptability profile among the three prolactin-sparing antipsychotics.

Conclusions: Quetiapine may offer an optimal benefit-risk balance when a prolactin-sparing antipsychotic is indicated.

EISSN 2475-0581