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Adverse effects of antipsychotics on sleep in patients with schizophrenia. Systematic review and meta-analysis

dc.creatorValencia Carlo, Yarmila Elenaes_ES
dc.creatorSaracco-Alvarez, Ricardo Arturoes_ES
dc.creatorValencia Carlo, Verónica Angelaes_ES
dc.creatorVázquez Vega, Danielaes_ES
dc.creatorNatera Rey, Guillerminaes_ES
dc.creatorEscamilla Orozco, Raul Ivanes_ES
dc.date2023
dc.date.accessioned2025-02-11T19:57:44Z
dc.date.available2025-02-11T19:57:44Z
dc.date.issued2023
dc.identifierJC03es_ES
dc.identifier.urihttp://repositorio.inprf.gob.mx/handle/123456789/8212
dc.identifier.urihttps://doi.org/10.3389/fpsyt.2023.1189768
dc.descriptionIntroduction: Our objective was to conduct a systematic review and meta-analysis of adverse effects on sleep in patients with schizophrenia receiving antipsychotic treatment. Methods: A systematic search was performed in PubMed, Cochrane Central, Embase, Toxline, Ebsco, Virtual Health Library, Web of Science, SpringerLink, and in Database of abstracts of Reviews of Effects of Randomized Clinical Trials to identify eligible studies published from January 1990 to October 2021. The methodological quality of the studies was evaluated using the CONSORT list, and the Cochrane bias tool. Network meta-analysis was performed using the Bayesian random-effects model, with multivariate meta-regression to assess the association of interest. Results: 87 randomized clinical trials were identified that met the inclusion criteria, and 70 articles were included in the network meta-analysis. Regarding the methodological quality of the studies, 47 had a low or moderate bias risk. The most common adverse effects on sleep reported in the studies were insomnia, somnolence, and sedation. The results of the network meta-analysis showed that ziprasidone was associated with an increased risk of insomnia (OR, 1.56; 95% credible interval CrI, 1.18-2.06). Several of the included antipsychotics were associated with a significantly increased risk of somnolence; haloperidol (OR, 1.90; 95% CrI, 1.12-3.22), lurasidone (OR, 2.25; 95% CrI, 1.28-3.97) and ziprasidone (OR, 1.79; 95% CrI, 1.06-3.02) had the narrowest confidence intervals. In addition, perphenazine (OR, 5.33; 95% CrI, 1.92-14.83), haloperidol (OR, 2.61; 95% CrI, 1.14-5.99), and risperidone (OR, 2.41; 95% CrI, 1.21-4.80) were associated with an increased risk of sedation compared with placebo, and other antipsychotics did not differ. According to the SUCRAs for insomnia, chlorpromazine was ranked as the lowest risk of insomnia (57%), followed by clozapine (20%), while flupentixol (26 %) and perospirone (22.5%) were associated with a lower risk of somnolence. On the other hand, amisulpride (89.9%) was the safest option to reduce the risk of sedation. Discussion: Insomnia, sedation, and somnolence were the most frequent adverse effects on sleep among the different antipsychotics administered. The evidence shows that chlorpromazine, clozapine, flupentixol, perospirone, and amisulpride had favorable safety profiles. In contrast, ziprasidone, perphenazine, haloperidol, and risperidone were the least safe for sleep. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42017078052, identifier: PROSPERO 2017 CRD42017078052.es_ES
dc.formatPDFes_ES
dc.language.isoenges_ES
dc.publisherFrontiers Research Foundationes_ES
dc.relation14:1189768
dc.rightsAcceso Cerradoes_ES
dc.titleAdverse effects of antipsychotics on sleep in patients with schizophrenia. Systematic review and meta-analysises_ES
dc.typeArtículoes_ES
dc.contributor.affiliationHealth Sciences Program, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico
dc.contributor.emaildr_saracco@yahoo.com.mx ; saracco@imp.edu.mx (Ricardo Arturo Saracco-Alvarez)
dc.relation.jnabreviadoFRONT PSYCHIATRY
dc.relation.journalFrontiers in Psychiatry
dc.identifier.placeSuiza
dc.date.published2023
dc.identifier.organizacionInstituto Nacional de Psiquiatría Ramón de la Fuente Muñiz
dc.identifier.eissn1664-0640
dc.identifier.doi10.3389/fpsyt.2023.1189768
dc.subject.kwAntipsychotics
dc.subject.kwSchizophrenia
dc.subject.kwInsomnia
dc.subject.kwSomnolence
dc.subject.kwSedation


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