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Figuras y tablas -
Figure 1

Comparison 1 HERBAL MEDICINE versus ANTIPSYCHOTICS, Outcome 1 Global state: Not improved/worse ‐ short term.
Figuras y tablas -
Analysis 1.1

Comparison 1 HERBAL MEDICINE versus ANTIPSYCHOTICS, Outcome 1 Global state: Not improved/worse ‐ short term.

Comparison 1 HERBAL MEDICINE versus ANTIPSYCHOTICS, Outcome 2 Behaviour: Leaving the study early ‐ short term.
Figuras y tablas -
Analysis 1.2

Comparison 1 HERBAL MEDICINE versus ANTIPSYCHOTICS, Outcome 2 Behaviour: Leaving the study early ‐ short term.

Comparison 2 HERBAL MEDICINE + ANTIPSYCHOTCS versus ANTIPSYCHOTICS, Outcome 1 Global state: 1. Not improved/worse ‐ medium term.
Figuras y tablas -
Analysis 2.1

Comparison 2 HERBAL MEDICINE + ANTIPSYCHOTCS versus ANTIPSYCHOTICS, Outcome 1 Global state: 1. Not improved/worse ‐ medium term.

Comparison 2 HERBAL MEDICINE + ANTIPSYCHOTCS versus ANTIPSYCHOTICS, Outcome 2 Global state: 2. Average score ‐ short term (CGI endpoint , high score=worse).
Figuras y tablas -
Analysis 2.2

Comparison 2 HERBAL MEDICINE + ANTIPSYCHOTCS versus ANTIPSYCHOTICS, Outcome 2 Global state: 2. Average score ‐ short term (CGI endpoint , high score=worse).

Comparison 2 HERBAL MEDICINE + ANTIPSYCHOTCS versus ANTIPSYCHOTICS, Outcome 3 Mental state: 1. Not improved ‐ various measures ‐ medium term.
Figuras y tablas -
Analysis 2.3

Comparison 2 HERBAL MEDICINE + ANTIPSYCHOTCS versus ANTIPSYCHOTICS, Outcome 3 Mental state: 1. Not improved ‐ various measures ‐ medium term.

Comparison 2 HERBAL MEDICINE + ANTIPSYCHOTCS versus ANTIPSYCHOTICS, Outcome 4 Mental state: 2. Average score (BPRS endpoint, high score=worse).
Figuras y tablas -
Analysis 2.4

Comparison 2 HERBAL MEDICINE + ANTIPSYCHOTCS versus ANTIPSYCHOTICS, Outcome 4 Mental state: 2. Average score (BPRS endpoint, high score=worse).

Study

Intervention

mean

SD

N

overall ‐ medium term ‐ BPRS

Zhang 1997

Herbal medicine + antipsychotics

13.4

6.7

66

Zhang 1997

Antipsychotics

26.6

15.2

57

negative symptoms ‐ short term ‐ SANS

Meng 1996

Ginkgo (EGb61)

37.1

16.0

21

Meng 1996

Antipsychotics

46.6

30.0

15

positive symptoms ‐ medium term ‐ SAPS

Zhang 2001

Ginkgo biloba (EGb) + haloperidol

7.1

8.4

56

Zhang 2001

Haloperidol

11

10.5

53

Figuras y tablas -
Analysis 2.5

Comparison 2 HERBAL MEDICINE + ANTIPSYCHOTCS versus ANTIPSYCHOTICS, Outcome 5 Mental state: 3. Average scores ‐ various scales (endpoint, high score=worse, skewed data).

Comparison 2 HERBAL MEDICINE + ANTIPSYCHOTCS versus ANTIPSYCHOTICS, Outcome 6 Mental state: 4. Average score ‐ negative symptoms ‐ medium term (SANS endpoint, high score=worse).
Figuras y tablas -
Analysis 2.6

Comparison 2 HERBAL MEDICINE + ANTIPSYCHOTCS versus ANTIPSYCHOTICS, Outcome 6 Mental state: 4. Average score ‐ negative symptoms ‐ medium term (SANS endpoint, high score=worse).

Comparison 2 HERBAL MEDICINE + ANTIPSYCHOTCS versus ANTIPSYCHOTICS, Outcome 7 Behaviour: Leaving the study early.
Figuras y tablas -
Analysis 2.7

Comparison 2 HERBAL MEDICINE + ANTIPSYCHOTCS versus ANTIPSYCHOTICS, Outcome 7 Behaviour: Leaving the study early.

Comparison 2 HERBAL MEDICINE + ANTIPSYCHOTCS versus ANTIPSYCHOTICS, Outcome 8 Adverse effects: 1. Various symptoms ‐ short term.
Figuras y tablas -
Analysis 2.8

Comparison 2 HERBAL MEDICINE + ANTIPSYCHOTCS versus ANTIPSYCHOTICS, Outcome 8 Adverse effects: 1. Various symptoms ‐ short term.

Study

Intervention

mean

SD

N

Zhang 2001

Ginkgo biloba (EGb) + haloperidol

1.8

2.8

56

Zhang 2001

Haloperidol

2.7

4.6

53

Figuras y tablas -
Analysis 2.9

Comparison 2 HERBAL MEDICINE + ANTIPSYCHOTCS versus ANTIPSYCHOTICS, Outcome 9 Adverse effects: 2. Average score ‐ short term (TESS endpoint, high score=worse, skewed data).

Comparison 3 SENSITIVITY ANALYSIS ‐ GINKGO BILOBA ALONE/NOT ALONE + ANTIPSYCHOTICS versus ANTIPSYCHOTICS, Outcome 1 Global state: Average score ‐ short term (CGI endpoint , high score=worse).
Figuras y tablas -
Analysis 3.1

Comparison 3 SENSITIVITY ANALYSIS ‐ GINKGO BILOBA ALONE/NOT ALONE + ANTIPSYCHOTICS versus ANTIPSYCHOTICS, Outcome 1 Global state: Average score ‐ short term (CGI endpoint , high score=worse).

Comparison 3 SENSITIVITY ANALYSIS ‐ GINKGO BILOBA ALONE/NOT ALONE + ANTIPSYCHOTICS versus ANTIPSYCHOTICS, Outcome 2 Mental state: 1. Average score (BPRS endpoint, high score=worse).
Figuras y tablas -
Analysis 3.2

Comparison 3 SENSITIVITY ANALYSIS ‐ GINKGO BILOBA ALONE/NOT ALONE + ANTIPSYCHOTICS versus ANTIPSYCHOTICS, Outcome 2 Mental state: 1. Average score (BPRS endpoint, high score=worse).

Comparison 3 SENSITIVITY ANALYSIS ‐ GINKGO BILOBA ALONE/NOT ALONE + ANTIPSYCHOTICS versus ANTIPSYCHOTICS, Outcome 3 Mental state: 2. Average score ‐ negative symptoms ‐ medium term (SANS endpoint, high score=worse).
Figuras y tablas -
Analysis 3.3

Comparison 3 SENSITIVITY ANALYSIS ‐ GINKGO BILOBA ALONE/NOT ALONE + ANTIPSYCHOTICS versus ANTIPSYCHOTICS, Outcome 3 Mental state: 2. Average score ‐ negative symptoms ‐ medium term (SANS endpoint, high score=worse).

Comparison 3 SENSITIVITY ANALYSIS ‐ GINKGO BILOBA ALONE/NOT ALONE + ANTIPSYCHOTICS versus ANTIPSYCHOTICS, Outcome 4 Behaviour: Leaving the study early.
Figuras y tablas -
Analysis 3.4

Comparison 3 SENSITIVITY ANALYSIS ‐ GINKGO BILOBA ALONE/NOT ALONE + ANTIPSYCHOTICS versus ANTIPSYCHOTICS, Outcome 4 Behaviour: Leaving the study early.

Comparison 1. HERBAL MEDICINE versus ANTIPSYCHOTICS

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Global state: Not improved/worse ‐ short term Show forest plot

1

90

Risk Ratio (M‐H, Fixed, 95% CI)

1.88 [1.24, 2.86]

2 Behaviour: Leaving the study early ‐ short term Show forest plot

1

90

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 1. HERBAL MEDICINE versus ANTIPSYCHOTICS
Comparison 2. HERBAL MEDICINE + ANTIPSYCHOTCS versus ANTIPSYCHOTICS

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Global state: 1. Not improved/worse ‐ medium term Show forest plot

1

123

Risk Ratio (M‐H, Fixed, 95% CI)

0.19 [0.06, 0.61]

2 Global state: 2. Average score ‐ short term (CGI endpoint , high score=worse) Show forest plot

2

103

Mean Difference (IV, Fixed, 95% CI)

‐0.46 [‐0.86, ‐0.06]

3 Mental state: 1. Not improved ‐ various measures ‐ medium term Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 overall ‐ BPRS

1

109

Risk Ratio (M‐H, Fixed, 95% CI)

0.78 [0.52, 1.16]

3.2 negative symptoms ‐ SANS

1

109

Risk Ratio (M‐H, Fixed, 95% CI)

0.87 [0.66, 1.15]

3.3 positive symptoms ‐ SAPS

1

109

Risk Ratio (M‐H, Fixed, 95% CI)

0.69 [0.48, 0.99]

4 Mental state: 2. Average score (BPRS endpoint, high score=worse) Show forest plot

4

724

Mean Difference (IV, Fixed, 95% CI)

‐3.33 [‐4.32, ‐2.34]

4.1 short term

2

103

Mean Difference (IV, Fixed, 95% CI)

‐2.41 [‐3.85, ‐0.97]

4.2 medium term

2

621

Mean Difference (IV, Fixed, 95% CI)

‐4.17 [‐5.54, ‐2.79]

5 Mental state: 3. Average scores ‐ various scales (endpoint, high score=worse, skewed data) Show forest plot

Other data

No numeric data

5.1 overall ‐ medium term ‐ BPRS

Other data

No numeric data

5.2 negative symptoms ‐ short term ‐ SANS

Other data

No numeric data

5.3 positive symptoms ‐ medium term ‐ SAPS

Other data

No numeric data

6 Mental state: 4. Average score ‐ negative symptoms ‐ medium term (SANS endpoint, high score=worse) Show forest plot

3

741

Mean Difference (IV, Fixed, 95% CI)

‐9.15 [‐12.10, ‐6.20]

7 Behaviour: Leaving the study early Show forest plot

6

1004

Risk Ratio (M‐H, Fixed, 95% CI)

0.30 [0.16, 0.58]

7.1 short term

2

107

Risk Ratio (M‐H, Fixed, 95% CI)

0.10 [0.01, 1.76]

7.2 medium term

4

897

Risk Ratio (M‐H, Fixed, 95% CI)

0.34 [0.17, 0.65]

8 Adverse effects: 1. Various symptoms ‐ short term Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

8.1 extrapyramidal

1

67

Risk Ratio (M‐H, Fixed, 95% CI)

0.55 [0.18, 1.64]

8.2 gastrointestinal ‐ constipation

1

67

Risk Ratio (M‐H, Fixed, 95% CI)

0.03 [0.00, 0.45]

9 Adverse effects: 2. Average score ‐ short term (TESS endpoint, high score=worse, skewed data) Show forest plot

Other data

No numeric data

Figuras y tablas -
Comparison 2. HERBAL MEDICINE + ANTIPSYCHOTCS versus ANTIPSYCHOTICS
Comparison 3. SENSITIVITY ANALYSIS ‐ GINKGO BILOBA ALONE/NOT ALONE + ANTIPSYCHOTICS versus ANTIPSYCHOTICS

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Global state: Average score ‐ short term (CGI endpoint , high score=worse) Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

1.1 ginkgo biloba alone

1

36

Mean Difference (IV, Fixed, 95% CI)

‐1.30 [‐2.29, ‐0.31]

1.2 other herbs combined

2

103

Mean Difference (IV, Fixed, 95% CI)

‐0.46 [‐0.86, ‐0.06]

2 Mental state: 1. Average score (BPRS endpoint, high score=worse) Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

2.1 ginkgo biloba alone

1

36

Mean Difference (IV, Fixed, 95% CI)

‐4.0 [‐5.97, ‐2.03]

2.2 other herbs combined

2

103

Mean Difference (IV, Fixed, 95% CI)

‐2.41 [‐3.85, ‐0.97]

3 Mental state: 2. Average score ‐ negative symptoms ‐ medium term (SANS endpoint, high score=worse) Show forest plot

3

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

3.1 ginkgo biloba alone

2

621

Mean Difference (IV, Fixed, 95% CI)

‐9.16 [‐12.52, ‐5.79]

3.2 other herbs combined

3

741

Mean Difference (IV, Fixed, 95% CI)

‐9.15 [‐12.10, ‐6.20]

4 Behaviour: Leaving the study early Show forest plot

6

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 short term ‐ ginkgo biloba alone

1

40

Risk Ratio (M‐H, Fixed, 95% CI)

0.10 [0.01, 1.76]

4.2 short term ‐ other herbs combined

2

107

Risk Ratio (M‐H, Fixed, 95% CI)

0.10 [0.01, 1.76]

4.3 medium term ‐ ginkgo biloba alone

2

654

Risk Ratio (M‐H, Fixed, 95% CI)

0.34 [0.17, 0.65]

4.4 medium term ‐ other herbs combined

4

897

Risk Ratio (M‐H, Fixed, 95% CI)

0.34 [0.17, 0.65]

Figuras y tablas -
Comparison 3. SENSITIVITY ANALYSIS ‐ GINKGO BILOBA ALONE/NOT ALONE + ANTIPSYCHOTICS versus ANTIPSYCHOTICS