Mark Fenton

Sulpiride Augmentation for Schizophrenia

Jijun Wang, Ichiro M. Omori, Mark Fenton, and Bernardo Soares Department of EEG Source Imaging, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, 600 Wan Ping NanRoad,Shanghai200030,Shanghai,China; CochraneSchizophreniaGroup,UniversityofNottingham,Nottingham,UK;Databaseof Uncertainties about the Effects of Treatments (DUETs), James Lind Initiative, Oxford, UK; Brazilian Cochrane Centre, Universidade Federal de Sao Paulo, Sao Paulo, Brazil

Overstatement in article

Dear Editor We disagree with the Cochrane Schizophrenia Group’s (CSzG) self-assessment that the problems we identified (Hutton, Wood, Taylor, Irving & Morrison, 2014) in their reviews of popular antipsychotics for schizophrenia are not serious. We encourage people to read the paper (Hutton et al., 2012) where we document the problems in great detail and their likely impact on estimates of efficacy. We have not examined their impact on estimates of adverse effects, but we invite readers to do so. We reject Professor Adams’ claim that the CSzG was not forewarned that there were serious problems with their review of cognitive behavioural therapy for psychosis (Jones, Hacker, Cormac, Meaden, & Irving, 2012). In a meeting with the CSzG Editors in 2012, one of us (Paul Hutton) called for both it and their review of risperidone (Rattehalli, Jayaram, & Smith, 2010) to be retracted, fixed and then re-issued. Despite assurances that our concerns would be followed up, we have received no correspondence since then. Both these reviews contain multiple errors which greatly undermine their negative conclusions, yet both have been allowed to continue to influence public policy and debate. As discussed at the 2012 meeting, we believe the CSzG system for documenting and responding to constructive criticism and feedback is neither transparent nor effective. Until there is evidence of improved responsiveness, we encourage readers to submit their critical feedback to independent and peer-reviewed journals, as we have done.

Sulpiride for schizophrenia: A cochrane systematic review

Intention-to-treat analyses were undertaken for dichotomous data and relative risk (RR) and numbers needed to treat/harm (NNT/H) calculated. Results The search 223 unique citations identified 120 clearly not relevant 103 papers (82 studies) acquired 21 more papers identified in references 60 studies excluded 18 studies included 6 await assessment Conclusions Sulpiride may be an effective antipsychotic drug but evidence is limited and data relating to claims for its value against negative symptoms are not trialbased.1