Antipsychotic Drugs and Cognitive Function: A Systematic Review and Pairwise Network Meta-Analysis
Abstract
Importance
Cognitive deficits are a substantial part of the symptoms of schizophrenia spectrum disorders (SSDs) and contribute heavily to the burden of disease. Antipsychotic drugs are not cognitive enhancers, but due to their different receptor-binding profiles, they could differ in their effects on cognition. No previous network meta-analysis compared antipsychotics to placebo, which is important to determine whether use of these drugs is associated with cognitive performance in SSDs at all.
Objective
To determine the association of treatment with various antipsychotics and cognition in patients with SSDs.
Data Sources
Cochrane Schizophrenia Trials Register through June 25, 2023.
Study Selection
Randomized clinical trials examining the effects on cognition of antipsychotic drugs or placebo in participants with SSD.
Data Extraction and Synthesis
A systematic review and random-effects frequentist network meta-analysis was performed following Preferred Reporting Items for Systematic Reviews and Meta-analyses-Network Meta-analysis reporting guideline.
Main Outcomes and Measures
The primary outcome was change in overall cognition score calculated for each study. Secondary outcomes included cognitive domains, quality of life, and functioning.
Results
This study included 68 studies involving 9525 participants (mean [SD] age, 35.1 [8.9] years; 5878 male [70%] and 2890 [30%] female; some studies did not provide this information). There were few clear differences between…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 9,525 participants or records.
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