Antidepressant and antipsychotic side-effects and personalised prescribing: a systematic review and digital tool development

作者：Toby Pillinger, Oliver Howes, Christoph U. Correll, Stefan Leucht, Maximilian Huhn, Johannes Schneider‐Thoma, Fiona Gaughran, Sameer Jauhar, Philip McGuire, David Taylor, Allan H. Young, Robert A. McCutcheon · 发表于：The Lancet Psychiatry · 年份：2023 · DOI：10.1016/s2215-0366(23)00262-6 · 被引用次数：146 · 研究领域：Treatment of Major Depression、Schizophrenia research and treatment、Digital Mental Health Interventions

BACKGROUND: Side-effects of psychiatric medication impair quality of life and functioning. Furthermore, they contribute to morbidity, mortality, stigma, and poor treatment concordance resulting in relapse of psychiatric illness. Guidelines recommend discussing side-effects with patients when making treatment decisions, but a synthesis of antidepressant and antipsychotic side-effects to guide this process is missing, and considering all side-effects is a complex, multidimensional process. We aimed to create comprehensive databases of antipsychotic and antidepressant side-effects, and a digital tool to support database navigation. METHODS: To create the databases, we did an umbrella review of Embase, PsycINFO, and MEDLINE from database inception to June 26, 2023. We included meta-analyses of randomised controlled trials examining antipsychotic monotherapy in the treatment of schizophrenia or antidepressant monotherapy in the treatment of major depressive disorder. We included meta-analyses in adults (aged ≥18 years) that assessed drugs with a common comparator. The search was complemented by a review of national and international guidelines and consensus statements for the treatment of major depressive disorder and schizophrenia in adults. Effect sizes for antipsychotic and antidepressant side-effects were extracted from meta-analyses examining the largest number of drugs. In cases of incomplete meta-analytic coverage, data were imputed on the basis of guideline-derived ordinal...