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In a latest research, investigators in contrast charges of somnolence/sedation with dopamine partial agonists vs D2 receptor antagonists within the adjunctive therapy of main depressive dysfunction (MDD) and the therapy of acute schizophrenia. Knowledge have been offered on the 2025 American Society of Medical Psychopharmacology Annual Assembly in Scottsdale, AZ.1
Somnolence/sedation are each adversarial results related to the usage of some atypical antipsychotics within the therapy of MDD and schizophrenia. They disrupt sleep high quality, can intrude with each day functioning, and negatively impression total high quality of life.2-5 The chance of somnolence/sedation can play a big position in influencing affected person and supplier selections concerning atypical antipsychotic therapy.6-8
Atypical antipsychotics will be categorized as both dopamine partial agonists, which act as purposeful agonists or antagonists relying on the encompassing ranges of endogenous dopamine, or dopamine D2 receptor antagonists (eg, quetiapine), which act as pure antagonists at these receptors.9 Nonetheless, the relative charges of somnolence/sedation related to dopamine partial agonists vs D2 receptor antagonists in MDD or schizophrenia are unclear. Investigators sought to raised perceive these charges by conducting 2 unbiased meta-analyses that used research recognized by prior systematic literature critiques.
The adjunctive MDD meta-analysis included randomized, double-blind, placebo-controlled, part 2 and three trials with a randomization part ≥6 weeks evaluating atypical antipsychotics authorized by the US Meals and Drug Administration for the adjunctive therapy of MDD in adults. The trials that have been included assessed somnolence as a binary end result.
The schizophrenia meta-analysis included double-blind, randomized, managed trials with a randomization part ≥4 weeks evaluating atypical antipsychotics for the therapy of acute schizophrenia in adults. The trials that have been included trials assessed somnolence/sedation as a binary end result. Excluded from the evaluation have been research populations with first episode schizophrenia, predominant unfavourable signs, or refractory illness. In research that reported each somnolence and sedation, the result with the very best variety of occasions was reported.
Investigators then used Bayesian community meta-analyses (NMAs) to guage the therapy impact of dopamine partial agonists and D2 receptor antagonists on somnolence in MDD or somnolence/sedation in schizophrenia. Statistical assessments of heterogeneity have been based mostly on mannequin match comparisons between fixed- and random-effects fashions utilizing the deviance info criterion (DIC). For schizophrenia, which used a random-effects mannequin, one other statistical measure (Ƭ2) was calculated.
For MDD, investigators included 10 research, then used a fixed-effects mannequin for evaluation, as a result of a decrease DIC in contrast with the random-effects mannequin (40.4 vs 41.8, respectively). The chances of experiencing somnolence have been 72% much less for sufferers taking dopamine partial agonists in contrast with these taking D2 receptor antagonists (OR [95% CrI], 0.28 [0.13, 0.59]).
For schizophrenia, investigators included 50 research. The chances of experiencing somnolence/sedation have been 57% much less for sufferers taking dopamine partial agonists in contrast with these taking D2 receptor antagonists (OR [95% CrI], 0.43 [0.26, 0.73]).
There was low to average heterogeneity noticed for the random-effects mannequin on somnolence/sedation (Ƭ2=0.14), which means that the variability amongst research outcomes is comparatively low. Investigators concluded that dopamine partial agonists could also be much less more likely to trigger somnolence in MDD or somnolence/sedation in schizophrenia in contrast with D2 receptor antagonists.
References
1. Nabulsi N, Ta J, Haile F, et al. Oblique therapy comparability of somnolence or sedation with dopamine partial agonists versus D2 receptor antagonists in main depressive dysfunction and schizophrenia. Poster offered at: 2025 American Society of Medical Psychopharmacology Annual Assembly; Might 27-30, 2025; Scottsdale, AZ. Accessed Might 29, 2025.
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