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Efficacy of betahistine in counteracting second-generation antipsychotics-induced weight gain: A meta-analysis with trial sequential analysis

Published online by Cambridge University Press:  19 July 2023

Y. Soliman ,
A. Azeez ,
W. Chibani ,
A. Mamdouh ,
B. Elawfi ,
A. M. Sharkawy ,
O. A. Abdelwahab  and
R. U. Awan
Y. Soliman*
Affiliation:
1Faculty of Medicine, Assiut University, Assiut
A. Azeez
Affiliation:
2Faculty of Medicine, Tanta University, Almahalla Alkubrah
W. Chibani
Affiliation:
3Faculty of Medicine, Cairo University, Cairo
A. Mamdouh
Affiliation:
4Faculty of Medicine, Misr University for Science and Technology, Giza, Egypt
B. Elawfi
Affiliation:
5Faculty of Medicine, Sana’a University, Sana’a, Yemen
A. M. Sharkawy
Affiliation:
6Faculty of Medicine, South Valley University, Qena
O. A. Abdelwahab
Affiliation:
7Faculty of Medicine, Al-Azhar University, Cairo, Egypt
R. U. Awan
Affiliation:
8Ochsner Health System, Mississippi, United States
*
*Corresponding author.

Abstract

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Introduction

Despite being effective in schizophrenia, second-generation antipsychotics are potent histamine-H1 receptor antagonists associated with weight gain. Histaminergic agonists can potentially counteract the weight gain effects of antipsychotics. Betahistine is a centrally acting histamine-H1 agonist and, therefore, may reduce antipsychotic-induced weight gain, but it has never been examined in a meta-analysis.

Objectives

This meta-analysis aims to examine the efficacy of betahistine in counteracting the weight gain effects of antipsychotics.

Methods

We searched PubMed, Scopus, Web of Science, and Cochrane Controlled Register of Trials (CENTRAL) for all relevant trials. We used Hedges’ g with its confidence interval as our effect size to correct for the small sample size. The primary outcomes of this study were changes in weight and body mass index (BMI). Changes in insulin resistance and lipid parameters were secondary outcomes.

Results

165 studies were included in the title/abstract screening, and 5 studies with 217 patients were finally included. Betahistine led to statistically significant changes in weight (Hedges’ g -1.13, 95% CI [-1.66, -0.60], p < 0001), BMI (Hedges’ g -1.64, 95% CI [-2.39, -0.89], p < 0.0001), and waist circumference (Hedges’ g -0.98, 95% CI [-1.47, -0.49], p < 0001). Nevertheless, betahistine did not lead to any significant changes in fasting glucose (Hedges’ g 0.02, 95% CI [-0.41, 0.44], p = 0.94) or insulin levels (Hedges’ g -0.07, 95% CI [-1.78, 1.64], p = 0.94).

Conclusions

Betahistine is an effective add-on treatment for second-generation antipsychotics to counteract weight gain experienced with these medications. Further trials are recommended to examine its effect on blood lipids and side effects.

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
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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