Beta-blocker supplementation of standard drug treatment for schizophrenia

Abstract

Background: Many people with schizophrenia or similar severe mental disorders do not achieve a satisfactory treatment response with ordinary antipsychotic drug treatment. In these cases, various add-on medications are used, among them beta-adrenergic receptor antagonists (beta-blockers). Objectives: To evaluate the clinical effects of beta-blockers as an adjunct to antipsychotic medication in schizophrenia or similar severe mental disorders. Search strategy: Publications in all languages were searched from the following databases: Biological Abstracts (1982-2000), The Cochrane Library (Issue 3, 2000), The Cochrane Schizophrenia Group's Register (November 2000), EMBASE (1980-2000), LILACS (1982-1996), MEDLINE (1966-2000) and PsycLIT (1974-2000). Reference sections of included papers were screened. Selection criteria: All randomised controlled trials comparing beta-blockers with placebo as an adjunct to conventional antipsychotic medication for those with schizophrenia. Data collection and analysis: Studies were selected and then data extracted, independently, by at least two reviewers. Odds ratios (OR) and 95% confidence intervals (CI) of homogeneous dichotomous data were calculated using the Peto method. A random effects model was used for heterogeneous dichotomous data. Weighted mean differences were calculated for continuous data. Main results: Currently the review includes five studies but data are poorly presented and there is no evidence of any effect of beta-blockers as an adjunct to conventional antipsychotic medication. Authors' conclusions: At present beta-blockers cannot be recommended in the treatment of schizophrenia. Any possible benefit of adjunctive beta-blockers is obscured by poor reporting within included studies. Existing data on beta-blockers as adjunctive medication to antipsychotics for those with schizophrenia should be collected and reanalysed in order to allow confident conclusions about the effect of this treatment or the need for further trials. © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.