• M Cheine, J Ahonen, and K Wahlbeck.
• Dept. of Psychiatry, University of Helsinki, Lapinlahdentie, Helsinki University Central Hospital, Finland, FIN-00029. maxim.cheine@huch.fi
• Cochrane Db Syst Rev. 2000 Jan 1 (2): CD000234.

BackgroundMany people with schizophrenia or similar severe mental disorders do not achieve a satisfactory treatment response with ordinary antipsychotic drug treatment. In these cases, various add-on medications are used, among them beta-adrenergic receptor antagonists (beta-blockers).ObjectivesTo evaluate the clinical effectiveness of beta-blockers as an adjunct to antipsychotic medication in schizophrenia or similar severe mental disorders.Search StrategyPublications in all languages were searched from the following databases: Biological Abstracts, CENTRAL of The Cochrane Library, Cochrane Schizophrenia Group's Specialised Register, EMBASE, LILACS, MEDLINE, and PsycLIT. The reference section of papers included were screened.Selection CriteriaAll randomised controlled trials comparing beta-blockers with placebo as an adjunct to conventional antipsychotic medication for those with schizophrenia.Data Collection And AnalysisStudies were selected and then data extracted, independently, by at least two reviewers. Odds ratios and 95% confidence intervals of homogeneous dichotomous data were calculated with the Peto method. A random effects model was used for heterogeneous dichotomous data. Weighted mean differences were calculated for continuous data.Main ResultsCurrently the review includes five studies but data are poorly presented and do not evidence any effect of beta-blockers as an adjunct to conventional antipsychotic medication.Reviewer's ConclusionsAt present beta-blockers cannot be recommended in the treatment of schizophrenia. Any possible benefit of adjunctive beta-blockers is obscured by the poor reporting of the included studies. Existing data on beta-blockers as adjunctive medication to antipsychotics for those with schizophrenia should be collected and re-analysed in order to allow confident conclusions about the effect of this treatment or the need for further trials.

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