Sex differences in antipsychotic side-effects and efficacy in adults with acute exacerbations ofschizophrenia: an individual-participant network meta-analysis

Schizophrenia is a disabling disorder which affects about 1% of people world-wide. Typical symptoms are hallucinations, people hear voices although nobody is in the room or see things which are not there, and delusions, these are firmly held beliefs that have no basis in facts. For example they believe that someone is following or trying to harm them, also called paranoia. After the acute phase of schizophrenia patients often suffer from reduced motivation and drive, and they withdraw from their friends and families. The main treatment are medicines called antipsychotic drugs which help to reduce these symptoms, but these drugs can have many side effects. Frequent side-effects are movement disorders, for example patients feel stiff or restless, weight gain, sedation or increase in prolactin, a hormone which is important for sexual functions. What is important is that there are differences between men and women when it comes to the effects of these drugs. For example, women are usually smaller and lighter than men. Therefore, they should need lower doses to obtain the same efficacy, and they should be more sensitive for side-effects. Unfortunately, so far studies have rarely analysed the effects of antipsychotics in men and women separately, the results are usually presented in combined form. Therefore, there aren't clear guidelines on how to use antipsychotic drugs best for each gender. To figure this out, we are planning to look at the information from lots of different studies. We will combine these data in a “network meta-analysis” which is a statistical technique to obtain the average efficacy and side-effects in women and in men. The results could help doctors make better choices for each person, and to create new guidelines for treating people with schizophrenia which take sex difference into account.