Comparative efficacy and tolerability of antidopaminergic and muscarinic antipsychotics for acute schizophrenia: a network meta-analysis of randomised controlled trials indexed in international Englis
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- #antipsychotics
- #network-meta-analysis
- #schizophrenia
- Comparative efficacy and tolerability of antidopaminergic and muscarinic antipsychotics for acute schizophrenia were analyzed.
- A new muscarinic receptor agonist, xanomeline-trospium, was licensed in 2024, offering potential to reduce adverse effects.
- The study included 438 RCTs, with 388 providing usable data from 78,193 participants.
- All antipsychotics reduced symptoms more than placebo, with clozapine, amisulpride, olanzapine, and risperidone showing higher efficacy.
- Adverse effects varied across medications, with partial dopamine agonists having better tolerability.
- Xanomeline-trospium lacked dopamine-blocking adverse effects but caused cholinergic and anticholinergic events.
- Future research should directly compare xanomeline-trospium with other antipsychotics and explore early clozapine use in schizophrenia.