Clinical efficacy and safety of folic acid and vitamin B12 for the adjuvant treatment of schizophrenia: a systematic review and meta-analysis.

Abstract

Given the different effects of folate and vitamin B12 on the ad-juvant treatment of schizophrenia (SCH), their efficacy and safety as adjuvant therapies for SCH were systematically evaluated by evidence-based medicine. Publication retrieval was performed using authoritative databases such as the Cochrane Library, PubMed, and Web of Science to screen randomized con-trolled trials (RCTs). After the quality evaluation and data extraction of includ-ed studies, eligible RCTs were systematically reviewed using Review Manager 5.2 software. In total, 14 RCTs were included. The results of the meta-analysis revealed that as the adjuvant therapy for SCH, vitamin B12 differed significantly from folate in terms of anxiety relief rate [odds ratio (OR)=1.28, 95% con-fidence interval (CI) (1.02, 1.61), p=0.03, I2 =0%, Z=2.13]. However, there were no significant differences in the incidence rate of mania [OR=1.13, 95% CI (0.78,1.65), p=0.65, I2=36%, Z=0.65], total efficacy [OR=1.06, 95% CI (0.72, 1.56), p=0.77, I2=0%, Z=0.30] and incidence rate of adverse reactions [OR=1.15, 95% CI (0.88, 1.49), p=0.31, I2=0%, Z=1.03]. Although folate and vitamin B12 exhibit no significant differences in the adjuvant treatment of SCH, vitamin B12 exerts markedly fewer side effects than folate drugs, and it is of de-terminant significance for the clinical adjuvant medication of SCH.