Summary of findings for the main comparison. NORADRENERGIC DRUGS compared to PLACEBO for antipsychotic‐induced tardive dyskinesia.
| NORADRENERGIC DRUGS compared to PLACEBO for antipsychotic‐induced tardive dyskinesia | ||||||
| Patient or population: patients with antipsychotic‐induced tardive dyskinesia Settings: inpatients in Austria and the USA Intervention: NORADRENERGIC DRUGS (alpha‐methyldopa, celiprolol) Comparison: PLACEBO | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| PLACEBO | NORADRENERGIC DRUGS | |||||
|
Tardive dyskinesia: No clinically important improvement follow‐up: 2 weeks |
1000 per 1000 | 330 per 1000 (140 to 800) | RR 0.33 (0.14 to 0.80) | 20 (1 study) | ⊕⊕⊝⊝ low1,2 | The included study evaluated alpha‐methyldopa. |
|
Tardive dyskinesia: deterioration follow‐up: 2 weeks |
100 per 1000 | 33 per 1000 (2 to 732) | RR 0.33 (0.02 to 7.32) | 20 (1 study) | ⊕⊝⊝⊝ very low1,3 | The included study evaluated alpha‐methyldopa. |
| Adverse events ‐ not reported | See comment | See comment | Not estimable | 0 (0) | See comment | We found no studies rating this outcome. |
| Mental state ‐ not reported | See comment | See comment | Not estimable | 0 (0) | See comment | We found no studies rating this outcome. |
|
Acceptability of treatment: Leaving the study early follow‐up: 13 weeks |
0 per 1000 | 0 per 1000 (0 to 0) | RR 5.28 (0.27 to 102.58) | 35 (1 study) | ⊕⊝⊝⊝ very low1,3 | The included study evaluated celiprolol. |
|
No improvement in quality of life follow‐up: 13 weeks |
944 per 1000 | 822 per 1000 (642 to 1000) | RR 0.87 (0.68 to 1.12) | 35 (1 study) | ⊕⊝⊝⊝ very low1,3 | The included study evaluated celiprolol. |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 Downgraded one step for risk of bias: unclear whether randomisation procedure and allocation concealment were carried out adequately, blinding of outcome assessors was not described. 2 Downgraded one step for imprecision: few events and small sample size. 3 Downgraded two steps for imprecision: few events, small sample size and wide CI that includes both no effect and appreciable benefit for intervention group. 4 Downgraded one level for indirectness: leaving the study early can give an indication, but is not a direct measurement, of treatment acceptability.