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Efficacy of probiotics and fibers on metabolic disturbances associated with antipsychotics: A systematic review and network meta-analysis
- Y. Soliman, N. I. Hendi, J. Magdy Daniel, M. Emara, N. M. Gharib, O. A. Abdelwahab, R. U. Awan
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S307-S308
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Introduction
Human gut microbiota plays an important role in metabolic health. Atypical antipsychotics can lead to metabolic abnormalities and changes in the gut microbiota. Multiple studies have examined the role of probiotics in suppressing antipsychotics-induced weight gain, but they have never been examined in a meta-analysis.
ObjectivesThis network meta-analysis aims to compare the effect of probiotics + fibers, probiotics only, and fibers only on metabolic abnormalities induced by atypical antipsychotics.
MethodsWe searched PubMed, Scopus, Web of Science, and Cochrane Controlled Register of Trials (CENTRAL) for all relevant studies. We used mean difference with its 95% confidence interval as our effect size. Primary outcomes were body weight and body mass index (BMI), while secondary outcomes were changes in other cardiometabolic risk factors.
ResultsWe included 4 randomized controlled trials comprising 319 patients. For body weight, probiotics + fibers (MD -3.96, 95% CI [-5.16, -2.76]), fibers only (MD -1.91, 95% CI [-3.81, -0.01]), and probiotics only (MD -1.37, 95% CI [-2.07, 0.66]) were significantly superior to placebo. Probiotics + fibers (MD -1.52, 95% CI [-2.11, -0.92]), but not fibers only or probiotics only, was associated with significant changes in BMI. Probiotics + fibers was also associated with significant changes in cholesterol (MD -0.37, 95% CI [-0.67, -0.07]), insulin levels (MD -3.37, 95% CI [-5.35, -2.10]), and insulin resistance index (MD -1.35, 95% CI [-1.94, -0.76]). There were no significant adverse events reported in the included studies.
ConclusionsProbiotics + fibers, probiotics only, and fibers can be effective in controlling antipsychotics-induced metabolic abnormalities, with probiotics + fibers being the most effective regimen. All three treatments were safe and well tolerated by patients.
Disclosure of InterestNone Declared
List of Contributors
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- By Harold P. Adams, Colum F. Amory, Anne Angelillo-Scherrer, Irena Anselm, Marcel Arnold, Robert W. Baloh, Ralf W. Baumgartner, José Biller, Valérie Biousse, Matthias Bischof, Julien Bogousslavsky, Natan M. Bornstein, Marie Germaine Bousser, Robin L. Brey, John C. M. Brust, Alan Bryer, Olivier Calvetti, Louis R. Caplan, José Castillo, Hugues Chabriat, Chin-Sang Chung, Charlotte Cordonnier, Steven C. Cramer, Luís Cunha, Rima M. Dafer, John F. Dashe, Cyrus K. Dastur, Antonio Dávalos, Larry E. Davis, Patricia Davis, Stephen M. Davis, Jan L. De Bleecker, Michael A. De Georgia, Amir R. Dehdashti, Oscar H. Del Brutto, Jacques L. De Reuck, Hans-Christoph Diener, Kathleen B. Digre, Vivian U. Fritz, Nancy Futrell, Bhuwan P. Garg, Philip B. Gorelick, Glenn D. Graham, Alexander Y. Gur, John J. Halperin, Michael Hennerici, Isabel Lestro Henriques, Roberto C. Heros, Daniel B. Hier, Lorenz Hirt, Joanna C. Jen, Taro Kaibara, Sumit Kapoor, Sarosh M. Katrak, Siddharth Kharkar, Walter J. Koroshetz, Monisha Kumar, Sandeep Kumar, Emre Kumral, Tobias Kurth, Rogelio Leira, Steven R. Levine, Didier Leys, Doris Lin, Jonathan Lipton, Alfredo M. Lopez-Yunez, Betsy B. Love, Ayrton Roberto Massaro, Heinrich P. Mattle, Manu Mehdiratta, John H. Menkes, Philippe Metellus, Reto Meuli, Patrik Michel, Panayiotis Mitsias, Jorge Moncayo-Gaete, Julien Morier, Krassen Nedeltchev, Bernhard Neundörfer, Olukemi A. Olugemo, Nikolaos I. H. Papamitsakis, Stephen D. Reck, Luca Regli, Marc D. Reichhart, Daniele Rigamonti, Michael J. Rivkin, E. Steve Roach, Jose F. Roldan, David Z. Rose, Daniel M. Rosenbaum, N. Paul Rosman, Elayna O. Rubens, Sean I. Savitz, Marc Schapira, Robert J. Schwartzman, Magdy Selim, Yukito Shinohara, Aneesh B. Singhal, Michael A. Sloan, Barney J. Stern, Mathias Sturzenegger, Oriana Thompson, A. Wesley Thevathasan, Jonathan D. Trobe, Michael Varner, Dana Védy, Jorge Vidaurre, Engin Y. Yilmaz, Khaled Zamel, Mathieu Zuber
- Edited by Louis R. Caplan, Julien Bogousslavsky
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- Book:
- Uncommon Causes of Stroke
- Published online:
- 06 January 2010
- Print publication:
- 09 October 2008, pp ix-xiv
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