Wei Zheng1, Xiao-Min Zhu2, Qing-E Zhang3, Gen Cheng3, Dong-Bin Cai4, Jie He5, Chee H Ng6, Gabor S Ungvari7,8, Xiao-Jiang Peng1, Yu-Ping Ning1, Yu-Tao Xiang9. 1. The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China. 2. Suzhou Guangji Hospital, the Affiliated Guangji Hospital of Soochow University, Suzhou, 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. Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China. 5. The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. 6. Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia. 7. The University of Notre Dame Australia, Fremantle, WA, Australia. 8. Division of Psychiatry, School of Medicine, University of Western Australia, Perth, WA, Australia. 9. Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
Abstract
OBJECTIVES: This meta-analysis of randomized controlled trials (RCTs) examined the efficacy and safety of minocycline for three major mental disorders: schizophrenia, bipolar disorder and major depressive disorder (MDD). METHODS: A systematic literature search of major electronic databases was conducted. Meta-analysis of clinical efficacy as defined by the respective studies, all-cause discontinuation, adverse drug reactions (ADRs) with standardized mean difference (SMD) and risk ratios (RRs) and their 95% confidence intervals (CI) was conducted using random-effects model. Quality assessment was performed with the Jadad scale and Cochrane risk of bias. RESULTS: Sixteen RCTs (n=1357) on minocycline (50-300 mg/day) for schizophrenia (13 RCTs, n=1196), bipolar depression (1 RCT, n=49), and MDD (2 RCTs, n=112) were analyzed separately by diagnosis. Twelve RCTs mentioned randomized allocation specifically; the weighted Jadad scores were 4.0. Adjunctive minocycline outperformed placebo in improving total psychopathology [SMD: -0.45 (95%CI: -0.73, -0.16), p=0.002; I2=77%], positive [SMD: -0.15 (95%CI: -0.28, -0.02), p=0.02; I2=0%], negative [SMD: -0.62 (95%CI: -0.95, -0.28), p=0.0003; I2=85%] and general psychopathology scores [SMD: -0.28 (95%CI: -0.53, -0.03), p=0.03; I2=59%] in schizophrenia. Minocycline showed no significant effect on depressive and manic symptoms in both bipolar depression and MDD. Minocycline caused significantly less headache (p=0.02, number-needed-to-harm=14, 95%CI=5-14) than placebo in schizophrenia. All-cause discontinuation and other ADRs were similar between minocycline and placebo in each diagnostic category. CONCLUSION: In this meta-analysis, adjunctive minocycline appeared to be efficacious and safe for schizophrenia. However, the efficacy of adjunctive minocycline for bipolar depression or MDD could not be demonstrated. REVIEW REGISTRATION: PROSPERO: CRD42018102483.
OBJECTIVES: This meta-analysis of randomized controlled trials (RCTs) examined the efficacy and safety of minocycline for three major mental disorders: schizophrenia, bipolar disorder and major depressive disorder (MDD). METHODS: A systematic literature search of major electronic databases was conducted. Meta-analysis of clinical efficacy as defined by the respective studies, all-cause discontinuation, adverse drug reactions (ADRs) with standardized mean difference (SMD) and risk ratios (RRs) and their 95% confidence intervals (CI) was conducted using random-effects model. Quality assessment was performed with the Jadad scale and Cochrane risk of bias. RESULTS: Sixteen RCTs (n=1357) on minocycline (50-300 mg/day) for schizophrenia (13 RCTs, n=1196), bipolar depression (1 RCT, n=49), and MDD (2 RCTs, n=112) were analyzed separately by diagnosis. Twelve RCTs mentioned randomized allocation specifically; the weighted Jadad scores were 4.0. Adjunctive minocycline outperformed placebo in improving total psychopathology [SMD: -0.45 (95%CI: -0.73, -0.16), p=0.002; I2=77%], positive [SMD: -0.15 (95%CI: -0.28, -0.02), p=0.02; I2=0%], negative [SMD: -0.62 (95%CI: -0.95, -0.28), p=0.0003; I2=85%] and general psychopathology scores [SMD: -0.28 (95%CI: -0.53, -0.03), p=0.03; I2=59%] in schizophrenia. Minocycline showed no significant effect on depressive and manic symptoms in both bipolar depression and MDD. Minocycline caused significantly less headache (p=0.02, number-needed-to-harm=14, 95%CI=5-14) than placebo in schizophrenia. All-cause discontinuation and other ADRs were similar between minocycline and placebo in each diagnostic category. CONCLUSION: In this meta-analysis, adjunctive minocycline appeared to be efficacious and safe for schizophrenia. However, the efficacy of adjunctive minocycline for bipolar depression or MDD could not be demonstrated. REVIEW REGISTRATION: PROSPERO: CRD42018102483.
Authors: Chiara C Bortolasci; Wolfgang Marx; Adam J Walker; Kyoko Hasebe; Bianca E Kavanagh; Margaret J Morris; Mohammadreza Mohebbi; Alyna Turner; Laura Gray; Lesley Berk; Ken Walder; Michael Berk; Olivia M Dean Journal: BMJ Open Date: 2020-03-19 Impact factor: 2.692
Authors: Diego Romero-Miguel; Marta Casquero-Veiga; Karina S MacDowell; Sonia Torres-Sanchez; José Antonio Garcia-Partida; Nicolás Lamanna-Rama; Ana Romero-Miranda; Esther Berrocoso; Juan C Leza; Manuel Desco; María Luisa Soto-Montenegro Journal: Int J Neuropsychopharmacol Date: 2021-09-21 Impact factor: 5.176