Objective To evaluate the efficacy and safety of 7 atypical antipsychotics combined with SSRIs in the treatment of refractory obsessive-compulsive disorder by means of network meta-analysis. Methods Computer search of CNKI, WanFang Data, VIP, CBM, PubMed, EMbase and Cochrane Library databases, and collect all atypical antipsychotics combined with SSRIs based on inclusion and exclusion criteria. Randomized controlled trials for the treatment of obsessive-compulsive disorder. The retrieval time is from the establishment of the database to June 2020. Two researchers independently screen the literature, screen the data and evaluate the risk of bias in the included studies. The studies that meet the standards are carried out using Stata 15.0 software data analysis. Results A total of 36 RCTs were included, including 7 atypical antipsychotics (Aripiprazole, Olanzapine, Quetiapine, Risperidone, Amisulpride, Ziprasidone, Paliperidone), including 2362 patients. The results of the network meta-analysis showed that: in terms of total effective rate, the order of the SUCAR sorting results
showed that Olanzapine+SSRIs, Paliperidone+SSRIs, Amisulpride+SSRIs, Risperidone+SSRIs, Quetiapine+SSRIs, Zipra- sidone+SSRIs, Aripiprazole+SSRIs, SSRIs, Placebo+SSRIs. In terms of Y-BOCS score,the order is Olanzapine+SSRIs, Paliperidone+SSRIs, Amisulpride+SSRIs,Quetiapine+SSRIs,Aripiprazole+SSRIs, Ziprasidone + SSRIs, Risperidone+SSRIs, SSRIs,Placebo + SSRIs.In terms of HAMA score, the order is Amisulpride+SSRIs, Aripiprazole+SSRIs, Quetiapine+SSRIs, Risperidone+SSRIs, SSRIs. In terms of TESS score, the order is Amisulpride + SSRIs, SSRIs, Paliperidone + SSRIs, Quetiapine + SSRIs, Ziprasidone + SSRIs, Risperidone + SSRIs, Aripiprazole + SSRIs, Placebo + SSRIs. Conclusion Atypical antipsychotics combined with SSRIs are better than SSRIs in treating refractory obsessive-compulsive disorder. Olanzapine has the best effect and Amisulpride has the highest safety. |