Adjunctive minocycline for major mental disorders: A systematic review

作者：Wei Zheng, Xiaomin Zhu, Qinge Zhang, Gen Cheng, Dong-Bin Cai, Jie He, Chee H. Ng, Gábor S. Ungvári, Xiao-Jiang Peng, Yuping Ning, Yu‐Tao Xiang · 发表于：Journal of Psychopharmacology · 年份：2019 · DOI：10.1177/0269881119858286 · 被引用次数：35 · 研究领域：Schizophrenia research and treatment、Psychedelics and Drug Studies、Tryptophan and brain disorders

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; I 2 =77%], positive [SMD: −0.15 (95%CI: −0.28, −0.02), p=0.02; I 2 =0%], negative [SMD: −0.62 (95%CI: −0.95, −0.28), p=0.0003; I 2 =85%] and general psychopathology scores [SMD: −0.28 (95%CI: −0.53, −0.03), p=0.03; I 2 =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-t...