Evidence map›Paper›PMID 30155842›Full record

SynthesisCNS drugs2018

Clozapine and Psychosocial Function in Schizophrenia: A Systematic Review and Meta-Analysis.

Andrew T Olagunju, Scott R Clark, Bernhard T Baune

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in CNS drugs, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Review
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  6. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Andrew T OlagunjuDiscipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Adelaide Health and Medical Sciences Building, Level 6, 57 North Terrace, Adelaide, SA, 5000, Australia.
Scott R ClarkDiscipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Adelaide Health and Medical Sciences Building, Level 6, 57 North Terrace, Adelaide, SA, 5000, Australia.
Bernhard T BauneDiscipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Adelaide Health and Medical Sciences Building, Level 6, 57 North Terrace, Adelaide, SA, 5000, Australia. bernhard.baune@adelaide.edu.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClozapine has unique efficacy for symptoms in treatment-resistant schizophrenia; however, symptomatic remission is not necessary nor sufficient for functional improvement. No study has pooled the effect of clozapine on psychosocial function across clinical trials.

objectiveWe conducted a systematic review and meta-analysis to compare the effects of clozapine with other antipsychotics on psychosocial function, and described the predictors of functional outcome.

methodsWe searched MEDLINE/PubMed, PsychINFO, EMBASE, CINAHL, Scopus, Web of Science, Cochrane Central Register of controlled trials and clinical trial registries till April 2018, with no language limits. Eligible studies were randomised controlled trials of clozapine vs. typical or atypical antipsychotics among adults with treatment-resistant schizophrenia. We included studies with flexible or fixed doses of antipsychotics within the therapeutic range to reflect naturalistic care. Effect sizes of studies were pooled using generic inverse variance and random-effects models and presented as standard mean differences. Study quality was assessed in accordance with the Cochrane Collaboration guideline, and subgroup analyses were carried out to identify potential moderators and methodological biases.

resultsNine studies with 1279 participants (69.7% male) were included. Clozapine showed beneficial effects on psychosocial function, but both short-term trials [n = 3; comparing 99 people taking clozapine with 97 controls (standardised mean difference = 0.04; 95% confidence interval - 0.24, 0.32; p = 0.77; I

conclusionsClozapine does not appear superior to other antipsychotics for improvement of psychosocial function. Standardisation of psychosocial function measurement is needed to improve the quality of evidence. Further exploration of the predictors of good psychosocial outcomes with clozapine treatment may improve personalisation of care.

Indexed as

Antipsychotic AgentsClinical Trials as TopicClozapineHumansSchizophreniaSchizophrenic PsychologyAntipsychotic AgentsClozapine

Identifiers

PMID30155842

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.