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Efficacy of probiotics and fibers on metabolic disturbances associated with antipsychotics: A systematic review and network meta-analysis

Published online by Cambridge University Press:  19 July 2023

Y. Soliman ,
N. I. Hendi ,
J. Magdy Daniel ,
M. Emara ,
N. M. Gharib ,
O. A. Abdelwahab  and
R. U. Awan
Y. Soliman*
Affiliation:
1Faculty of Medicine, Assiut University, Assiut
N. I. Hendi
Affiliation:
2Faculty of Medicine, Ain Shams University, Cairo
J. Magdy Daniel
Affiliation:
3Faculty of Medicine, Menofia University, Menofia
M. Emara
Affiliation:
4Faculty of Medicine, Port Said University, Port Said
N. M. Gharib
Affiliation:
5Faculty of Medicine, Alexandria University, Alexandria
O. A. Abdelwahab
Affiliation:
6Faculty of Medicine, Al-Azhar University, Cairo, Egypt
R. U. Awan
Affiliation:
7Ochsner Health System, Mississippi, United States
*
*Corresponding author.

Abstract

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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.

Objectives

This network meta-analysis aims to compare the effect of probiotics + fibers, probiotics only, and fibers only on metabolic abnormalities induced by atypical antipsychotics.

Methods

We 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.

Results

We 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.

Conclusions

Probiotics + 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 Interest

None Declared

Type
Abstract
Information
European Psychiatry , Volume 66 , Special Issue S1: Abstracts of the 31st European Congress of Psychiatry , March 2023 , pp. S307 - S308
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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