Statin add-on therapy in the antipsychotic treatment of schizophrenia: A meta-analysis

A comprehensive meta-analysis of statin add-on therapy in the antipsychotic treatment of schizophrenia was conducted. Data from previous studies, prior to 8/21/2017, was obtained from Scopus, PubMed, PsycINFO, and Cochrane Library. Both a systematic review and meta-analysis were conducted with patient data from randomized placebo-controlled trials (RCTs) to compare statins with placebo in order to calculate effect size. Across the five RCTs (mean duration: 9.2 weeks), 236 adult patients with schizophrenia were randomly selected to receive either placebo (n=117) or statins (n=119). Pooled statin add-on therapy showed significant superiority over placebo in the improvement of Positive and Negative Syndrome Scale (PANSS) total scores (mean difference=-1.96; 95% confidence interval, -2.94 to -0.98; p<0.0001; I²=0%; N=4, n=174). However, there were no statistically significant differences in other efficacy outcomes between the two treatment groups. Statin did not have a significant difference in its incidence of discontinuation or have individual adverse events compared to placebo. Our results suggest that statins may have considerable potential as an add-on therapy for schizophrenia. However, determining the effectiveness of this treatment in clinical practice requires future investigation due to limitations of the current evidence-base including small sample, potential for publication and selection biases and short duration of follow-up.