Cochrane · systematic review · CD003834
Lithium for schizophrenia
Leucht, S, Helfer, B, Dold, M, et al. · Cochrane Database of Systematic Reviews · 2015 · Cochrane Library
SchizophreniaAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
15
No studies
6
Included studies
NR
No studies 6 · 28.6%Ungraded 0 · 0%Very low 2 · 9.5%Low 13 · 61.9%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Lithium as sole treatment compared with placebo as sole treatment for schizophrenia
Population: participants with schizophrenia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Response to treatment clinically relevant response as defined by the authors Lithium as sole treatment vs placebo | RR 0.83 [0.44, 1.55] | 2 studies · 54 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Acceptability of treatment leaving early due to any reason Lithium as sole treatment vs placebo | RR 1.14 [0.29, 4.44] | 3 studies · 65 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Clinically significant response on depressive symptoms at least 50% MADRS improvement Lithium as sole treatment vs placebo | RR 1.43 [0.65, 3.16] | 1 study · 39 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Clinically significant response on manic symptoms at least 50% Bech‐Rafaelsen improvement Lithium as sole treatment vs placebo | RR 1.03 [0.38, 2.81] | 1 study · 39 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Clinically significant response on positive symptoms at least 50% MS improvement Lithium as sole treatment vs placebo | RR 0.86 [0.44, 1.69] | 1 study · 39 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Kidney dysfunction outcome not available in any study Lithium as sole treatment vs placebo | no estimate extracted | NR | No studies |
Thyroid dysfunction outcome not available in any study Lithium as sole treatment vs placebo | no estimate extracted | NR | No studies |
Lithium compared with antipsychotics for schizophrenia
Population: participants with schizophrenia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Response to treatment clinically relevant response as defined by the authors Lithium vs antipsychotics | RR 0.72 [0.28, 1.84] | 3 studies · 80 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Acceptability of treatment leaving early due to any reason Lithium vs antipsychotics | RR 1.77 [1.01, 3.11] | 8 studies · 270 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Clinically significant response on depressive symptoms at least 50% MADRS improvement Lithium vs antipsychotics | RR 0.73 [0.43, 1.25] | 1 study · 44 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Clinically significant response on manic symptoms at least 50% Bech‐Rafaelsen improvement Lithium vs antipsychotics | RR 0.51 [0.24, 1.09] | 1 study · 44 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Clinically significant response on positive symptoms at least 50% MS improvement Lithium vs antipsychotics | RR 0.49 [0.29, 0.83] | 1 study · 44 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Kidney dysfunction outcome not available in any study Lithium vs antipsychotics | no estimate extracted | NR | No studies |
Thyroid dysfunction outcome not available in any study Lithium vs antipsychotics | no estimate extracted | NR | No studies |
Adjunctive lithium + antipsychotics compared with placebo/no adjunctive treatment + antipsychotics for schizophrenia
Population: participants with schizophrenia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Response to treatment clinically relevant response as defined by the authors Adjunctive lithium + antipsychotics vs placebo/no adjunctive treatment + antipsychotics | RR 1.81 [1.1, 2.97] | 10 studies · 396 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Acceptability of treatment leaving early due to any reason Adjunctive lithium + antipsychotics vs placebo/no adjunctive treatment + antipsychotics | RR 1.89 [0.93, 3.84] | 11 studies · 320 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Clinically significant response on depressive symptoms at least 50% MADRS improvement Adjunctive lithium + antipsychotics vs placebo/no adjunctive treatment + antipsychotics | RR 1.05 [0.69, 1.58] | 1 study · 45 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Clinically significant response on manic symptoms at least 50% Bech‐Rafaelsen improvement Adjunctive lithium + antipsychotics vs placebo/no adjunctive treatment + antipsychotics | RR 1.13 [0.7, 1.82] | 1 study · 45 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Clinically significant response on positive symptoms at least 50% MS improvement Adjunctive lithium + antipsychotics vs placebo/no adjunctive treatment + antipsychotics | RR 0.84 [0.62, 1.13] | 1 study · 45 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Kidney dysfunction outcome not available in any study Adjunctive lithium + antipsychotics vs placebo/no adjunctive treatment + antipsychotics | no estimate extracted | NR | No studies |
Thyroid dysfunction outcome not available in any study Adjunctive lithium + antipsychotics vs placebo/no adjunctive treatment + antipsychotics | no estimate extracted | NR | No studies |