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There is contrasting evidence on a possible role of melatonin and melatonin\u2010agonists in attenuating antipsychotic\u2010induced metabolic abnormalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>We conducted a systematic review (PubMed, PsycInfo, Cochrane databases, up to August 2020) and a random\u2010effect meta\u2010analysis of double\u2010blind, randomized placebo\u2010controlled trials (RCTs) involving melatonin and melatonin\u2010agonists in the treatment of antipsychotic\u2010induced metabolic changes. The primary outcome was the standardized mean difference (SMD) of composite metabolic outcomes built with metabolic syndrome components. Secondary outcomes were individual metabolic syndrome components, and other anthropometric, glucose metabolism, lipid profile, and psychopathology measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of the initial 41 studies, six documented five separate RCTs randomizing 248 patients (126 to melatonin\/ramelteon, 122 to placebo) affected by schizophrenia\u2010spectrum disorders and bipolar disorder. Melatonin\/ramelteon outperformed placebo on the primary outcome (SMD \u22120.28, 95% CI\u00a0=\u00a0\u22120.39\u00a0\u00f7\u00a0\u22120.168), as well as on all individual components of metabolic syndrome (systolic blood pressure MD \u22123.266, 95% CI\u00a0=\u00a0\u22126.020\u00a0\u00f7\u00a0\u22120.511; fasting glucose MD \u22123.766, 95% CI\u00a0=\u00a0\u22125.938\u00a0\u00f7\u00a0\u22121.593; triglycerides MD \u22129.800, 95% CI\u00a0=\u00a0\u221219.431\u00a0\u00f7\u00a0\u22120.169; HDL MD 2.995, 95% CI\u00a0=\u00a00.567\u00a0\u00f7\u00a05.423), except waist circumference.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Melatonin\/ramelteon augmentation may be beneficial for non\u2010anthropometric metabolic syndrome components in patients treated with antipsychotics.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hup.2821","type":"journal-article","created":{"date-parts":[[2021,10,23]],"date-time":"2021-10-23T06:16:59Z","timestamp":1634969819000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Melatonin and melatonin\u2010agonists for metabolic syndrome components in patients treated with antipsychotics: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2513-2718","authenticated-orcid":false,"given":"Alessandro","family":"Miola","sequence":"first","affiliation":[{"name":"Department of Neuroscience University of Padova Padua Italy"},{"name":"Padua Neuroscience Center University of Padova Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9647-0853","authenticated-orcid":false,"given":"Michele","family":"Fornaro","sequence":"additional","affiliation":[{"name":"Section of Psychiatry Department of Neuroscience, Reproductive Sciences and Dentistry Federico II University Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7423-0090","authenticated-orcid":false,"given":"Fabio","family":"Sambataro","sequence":"additional","affiliation":[{"name":"Department of Neuroscience University of Padova Padua Italy"},{"name":"Padua Neuroscience Center University of Padova Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4877-7233","authenticated-orcid":false,"given":"Marco","family":"Solmi","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Ottawa Ottawa Ontario Canada"},{"name":"Department of Mental Health The Ottawa Hospital Ottawa Ontario Canada"},{"name":"Clinical Epidemiology Program Ottawa Hospital Research Institute (OHRI) University of Ottawa Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2017.08.004"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.4260"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(99)00112-5"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0b013e31822bb573"},{"key":"e_1_2_8_6_1","unstructured":"Borenstein M. 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