Peng Tzu-Rong, Lin Hung-Hong, Wang Jian-Ying, Lee Ming-Chia, Chen Shih-Ming
Department of Pharmacy, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.
Brain Behav. 2025 Jul;15(7):e70649. doi: 10.1002/brb3.70649.
Raloxifene may be useful as an adjunctive treatment for schizophrenia, particularly in addressing psychotic symptoms. This meta-analysis aimed to evaluate the effectiveness and safety of adjunctive raloxifene in improving positive, negative, and general psychopathology symptoms, as measured by the Positive and Negative Syndrome Scale (PANSS).
A systematic search was performed using PubMed, Embase, and the Cochrane Library databases for articles published until May 2024. Randomized controlled trials investigating the effectiveness and safety of adjunctive raloxifene for treating schizophrenia were included. The primary outcome was psychotic symptom severity using PANSS subscales. Mean differences (MDs) and their 95% confidence intervals (CIs) were calculated using random effects models.
Ten studies were included in the final analysis. Compared with the placebo group, raloxifene as an adjunctive therapy significantly improved the positive, negative, general, and total PANSS scores, MD = -1.00 (95% CI = -2.00 to -0.20; I = 48%; p = 0.02; τ = 0.87), MD = -1.35 (95% CI = -2.74 to 0.04; I = 71%; p = 0.06; τ = 3.27), MD = -3.29 (95% CI = -5.74 to -0.83; I = 74%; p = 0.009; τ = 9.59), and MD = -7.12 (95% CI = -11.89 to -2.36; I = 74%; p = 0.003; τ = 41.86), respectively.
Adjunctive raloxifene appears to be a safe and effective treatment for improving positive, general, and total symptoms in patients with schizophrenia, particularly in those with mild-to-moderate illness and postmenopausal women. The 60 mg daily dose over at least 12 weeks yielded the most consistent benefits. Further high-quality trials are needed to confirm its efficacy across diverse populations and guide personalized treatment strategies.
雷洛昔芬可能作为精神分裂症的辅助治疗药物有用，尤其是在解决精神病性症状方面。本荟萃分析旨在评估辅助使用雷洛昔芬在改善阳性、阴性和一般精神病理学症状方面的有效性和安全性，这些症状通过阳性和阴性症状量表（PANSS）进行测量。
使用PubMed、Embase和Cochrane图书馆数据库进行系统检索，以查找截至2024年5月发表的文章。纳入了调查辅助使用雷洛昔芬治疗精神分裂症的有效性和安全性的随机对照试验。主要结局是使用PANSS分量表评估的精神病性症状严重程度。使用随机效应模型计算平均差异（MDs）及其95%置信区间（CIs）。
最终分析纳入了10项研究。与安慰剂组相比，雷洛昔芬作为辅助治疗显著改善了阳性、阴性、一般和PANSS总分，MD分别为=-1.00（95%CI=-2.00至-0.20；I=48%；p=0.02；τ=0.87），MD=-1.35（95%CI=-2.74至0.04；I=71%；p=0.06；τ=3.27），MD=-3.29（95%CI=-5.74至-0.83；I=74%；p=0.009；τ=9.59），以及MD=-7.12（95%CI=-11.89至-2.36；I=74%；p=0.003；τ=41.86）。
辅助使用雷洛昔芬似乎是改善精神分裂症患者阳性、一般和总体症状的一种安全有效的治疗方法，特别是在轻度至中度疾病患者和绝经后女性中。每天60毫克的剂量至少服用12周产生的益处最为一致。需要进一步的高质量试验来确认其在不同人群中的疗效并指导个性化治疗策略。
