The efficacy and safety of olanzapine combined with fluoxetine in the treatment of negative symptoms of schizophrenia:a systematic review / 中国神经精神疾病杂志

ABSTRACT

Objective To undertake a systematic review to evaluate the efficacy and safety of olanzapine combined with fluoxetine in the treatment of negative symptoms of schizophrenia. Methods Articles published before May 31, 2017 were identified by searching the PubMed, Medline,Web of science excerpta medica database (EMBASE), Cochrane Library,China national knowledge infrastructure (CNKI), WanFang data, using the key words fluoxetine, olanzapine, schizophren* and schizophrenia. Statistical analysis were conducted by Review Manager 5.3 software according to Cochrane Handbook for meta analysis. Result A total of 5 randomized,controlled studies were included(3 Chinese and 2 English). Meta analysis showed that the efficacy of olanzapine combined with fluoxetine (combination group) in the treatment of the negative symptoms in schizophrenia was not significant difference from olanzapine alone (standradization of mean difference(SMD)=-0.61,95% CI:-1.30~0.08,P=0.08).Due to the high heterogeneity of the five studies (I2=83%>75%), Subgroup analysis which was conducted in three domestic research revealed that combination group exhibited a better efficacy in the treatment of negative symptoms in negative symptoms predominant schizophrenia (defined as score of PANSS negative subscale >30)(SMD=-1.19, 95% CI:-1.52~-0.86, P<0.01) and a lower risk to develop weight gain (SMD=0.28, 95% CI:0.13~0.57, P<0.01). Conclusion Domestic studies have provided the initial evidence that olanzapine in combination with fluoxetine is more effective and has a lower risk of weight gain than olanzapine alone in the treatment of negative symptoms for schizophrenics..