Melatonin for prevention of metabolic side-effects of olanzapine in patients with first-episode schizophrenia: Randomized double-blind placebo-controlled study

Modabbernia, Amirhossein; Heidari, Parvaneh; Soleimani, Robabeh; Sobhani, Abdolrasoul; Roshan, Zahra Atrkar; Taslimi, Shervin; Ashrafi, Mandana; Modabbernia, Mohammad Jafar

doi:10.1016/j.jpsychires.2014.02.013

Cited by 90 publications

(76 citation statements)

References 47 publications

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“…In four studies, a computer random number generator was used to generate random sequences (low risk of selection bias) 13,21–23). Allocation concealment was adequate in all trials, except in one,20) which did not report enough information to judge this methodological issue.…”

Section: Risk Of Biasmentioning

confidence: 99%

“…Data for this comparison was derived from three studies 13,22,23). Results from these three studies were pooled for meta-analysis.…”

Section: Intervention Effectsmentioning

confidence: 99%

“…Results from these three studies were pooled for meta-analysis. In one study,13) participants were randomly allocated to receive either olanzapine 25 mg/day and melatonin 3 mg (active group) or olanzapine 25 mg/day and placebo (control group). In the second study,22) patients who had initiated continuous treatment with antipsychotics (clozapine, olanzapine, quetiapine, or risperidone) for a period no greater than three months prior to their inclusion in the study were allocated either 5 mg slow-release melatonin or placebo; results were then analyzed according to the metabolic risk of the anti-psychotics.…”

Section: Intervention Effectsmentioning

confidence: 99%

“…The three trials were conducted in adolescents23) or adults13,22) affected by schizophrenia or bipolar disorders treated with olanzapine or clozapine. In these studies, participants had no concomitant medical or neurological illnesses and no known risk factors for metabolic disturbances.…”

Section: Intervention Effectsmentioning

confidence: 99%

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Does Melatonin and Melatonin Agonists Improve the Metabolic Side Effects of Atypical Antipsychotics?: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Igwe

Brigo

2018

Clin Psychopharmacol Neurosci

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Atypical antipsychotics (AAPs) are increasingly used for the treatment of psychotic disorders but are known to be associated with metabolic abnormalities. This study is a systematic review and meta-analysis of randomized controlled trials (RCTs) studying the effectiveness of melatonin for the amelioration of AAP-induced metabolic syndrome. The MEDLINE (accessed via PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials, PsycINFO, LILACS, CINAHL, and OpenGrey databases were searched for RCTs without language restrictions. Inclusion criteria were randomized, double-blind clinical trials comparing melatonin or melatonin agonists with placebo for the amelioration of AAP-induced effects at any age with selected components of metabolic syndrome as outcome measures. Two reviewers independently selected articles and assessed quality using Cochrane risk of bias and concealment tools. Of 53 records, five RCTs were eligible for the systematic review and three for the meta-analysis. The meta-analyses showed no statistically significant difference in any anthropometric or metabolic variable considered. Analysis according to psychiatric diagnosis from one RCT showed significant decreases in diastolic blood pressure (5.5 vs. −5.7 mmHg for the placebo and melatonin groups, respectively; p=0.001), fat mass (2.7 vs. 0.2 kg, respectively; p=0.032), and triglycerides (D) (50.1 vs. −20 mg/dl, respectively; p=0.08) in the bipolar group but not the schizophrenia group. Although limited to five RCTs with small sample sizes, evidence from RCT indicates that melatonin improves AAP-induced metabolic syndrome. This beneficial effect seems more significant in patients with bipolar disorder than those with schizophrenia. Further RCTs are needed to definitively establish the potential ameliorative effect of melatonin and to justify its efficacy as an add-on therapy to curtail AAP-induced metabolic syndrome.

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Section: Risk Of Biasmentioning

confidence: 99%

“…Data for this comparison was derived from three studies 13,22,23). Results from these three studies were pooled for meta-analysis.…”

Section: Intervention Effectsmentioning

confidence: 99%

Section: Intervention Effectsmentioning

confidence: 99%

Section: Intervention Effectsmentioning

confidence: 99%

See 2 more Smart Citations

Does Melatonin and Melatonin Agonists Improve the Metabolic Side Effects of Atypical Antipsychotics?: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Igwe

Brigo

2018

Clin Psychopharmacol Neurosci

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“…Animal models of obesity showed that melatonin also possesses cytoprotective properties which may prevent undesirable effects [143,144] such as inflammation process and others [96,145] . On the other hand, several controlled trials have shown that melatonin administration is useful for treating metabolic and cardiovascular comorbidities [146][147][148][149][150] . As already mentioned, at an early stage, nonpharmacological approaches are highly recommended, while drug treatment may be used in patients refractory to those approaches.…”

Section: A Chronobiological Approach To Obesity Treatmentmentioning

confidence: 99%

White Adipose Tissue and Circadian Rhythm Dysfunctions in Obesity: Pathogenesis and Available Therapies

2016

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A combined neuroendocrine, metabolic, and chronobiological view can help to better understand the multiple and complex mechanisms involved in obesity development and maintenance, as well as to provide new effective approaches for its control and treatment. Indeed, we have currently updated data on the whole adipogenic process involved in white adipose tissue (WAT) mass expansion, namely due to a mechanism whereby WAT cells become hypertrophic, thus inducing a serious local (WAT) inflammatory condition that in turn, will impair not only the cross-talk between the hypothalamus and the WAT, but also favoring the development of deep and widespread neuroendocrine-metabolic dysfunction. Moreover, we also have revisited the circadian clock genes involved in dysfunctional WAT mass expansion and the mechanisms that may lead to obesity development, including early metabolic dysfunctions, enhanced oxidative stress and distorted energy homeostasis. The epigenetic changes of clock genes driving metabolic disease and obesity development have also been included in this review. Finally, we have also underlined the relevance of metabolic homeostasis regulation by central and peripheral organ clocks, sleep disturbances, nutrients, and feeding time, as key factors in obesity development as well as both, classical and chronotherapeutic approaches for its prevention and treatment.

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Interventions for preventing type 2 diabetes in adults with mental disorders in low- and middle-income countries

Mishu

Uphoff

Aslam

et al. 2021

Cochrane Database of Systematic Reviews

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Melatonin for prevention of metabolic side-effects of olanzapine in patients with first-episode schizophrenia: Randomized double-blind placebo-controlled study

Cited by 90 publications

References 47 publications

Does Melatonin and Melatonin Agonists Improve the Metabolic Side Effects of Atypical Antipsychotics?: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Does Melatonin and Melatonin Agonists Improve the Metabolic Side Effects of Atypical Antipsychotics?: A Systematic Review and Meta-analysis of Randomized Controlled Trials

White Adipose Tissue and Circadian Rhythm Dysfunctions in Obesity: Pathogenesis and Available Therapies

Interventions for preventing type 2 diabetes in adults with mental disorders in low- and middle-income countries

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