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Chinese herbal medicine for schizophrenia

Cochrane systematic review of randomised trials

Cochrane Schizophrenia Group, Academic Department of Psychiatry and Behavioural Sciences, University of Leeds UK

Lan Zhang, MD

Institute of Mental Health, Chengdu, China

Mingming Zhang, MSc

Chinese Cochrane Centre, West China Hospital of Sichuan University, Chengdu, China

Jun Xia, BSc

Cochrane Schizophrenia Group, Academic Department of Psychiatry and Behavioural Sciences, University of Leeds, UK

Xiehe Liu, MD and Yanchun Yang, MD

Institute of Mental Health, West China Hospital of Sichuan University, Chengdu, China

Clive E. Adams, MD

Cochrane Schizophrenia Group, Academic Department of Psychiatry and Behavioural Sciences, University of Leeds, UK

Correspondence: John Rathbone, Rathbone, Cochrane Schizop Schizophrenia hrenia Group, Academic Department of Psychiatry and Behavioural Sciences, University of Leeds,15 Hyde Terrace, Leeds LS2 9LT, UK. Tel: +44 (0)113 343 1897; fax: +44 (0)113 3432723; email: jrathbone{at}cochrane-sz.org

Declaration of interest None.

Background Chinese herbal medicine has been used to treat millions of people with schizophrenia for thousands of years.

Aims To evaluate Chinese herbal medicine as a treatmentfor schizophrenia.

Method A systematic review of randomised controlled trials (RCTs).

Results Seven trials were included. Most studies evaluated Chinese herbal medicine in combination with Western antipsychotic drugs; in these trials results tended to favour combination treatment compared with antipsychotic alone (Clinical Global Impression `not improved/worse' n=123, RR=0.19, 95% CI 0.1-0.6, NNT=6,95% CI 5-11; n=109, Brief Psychiatric Rating Scale `not improved/worse' RR=0.78,95% CI 0.5-1.2; n=109, Scale for the Assessment of Negative Symptoms `not improved/worse' RR=0.87,95% CI 0.7-1.2; n=109, Scale for the Assessment of Positive Symptoms `not improved/worse' RR=0.69,95% CI 0.5-1.0, NNT=6 95% CI 4-162). Medium-term study attrition was significantlyless for people allocated the herbal/antipsychotic mix (n=897, four RCTs, RR=0.34,95% CI 0.2-0.7, NNT=23,95% CI18-43).

Conclusions Results suggest that combining Chinese herbal medicine with antipsychotics is beneficial.

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