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.

Reviewer's 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 re-analysed in order to allow confident conclusions about the effect of this treatment or the need for further trials.