In the present study, a comprehensive systematic review and meta-analysis were conducted to assess the short-term efficacy and safety of blonanserin compared with control interventions, including placebo, risperidone, and haloperidol, in the treatment of schizophrenia. The goal was to provide a robust pharmacological foundation to inform clinical decision-making regarding the therapeutic use of blonanserin. We systematically searched five major databases-PubMed, Web of Science, Scopus, CNKI, and the WanFang Database-for randomized controlled trials (RCTs) evaluating blonanserin against standard comparators in patients with schizophrenia. Key data extracted included study authorship, publication year, geographic location, diagnostic criteria, sample size, treatment duration, dosing regimen, and clinical outcomes. Meta-analytic synthesis was performed using RevMan 5.3 software. Out of an initial pool of 718 articles, 11 trials met the inclusion criteria and were incorporated into the final analysis. In terms of clinical efficacy, short-term administration of blonanserin demonstrated non-inferiority to risperidone, with no indication of inferior performance across Positive and Negative Syndrome Scale (PANSS) subscales. Moreover, blonanserin significantly outperformed the placebo in terms of PANSS response rates, underscoring its therapeutic potential in managing acute symptoms. Regarding safety, the incidence of overall and serious adverse events did not differ significantly between blonanserin and the comparator agents. However, noteworthy distinctions were observed in the adverse event profiles (≥ 5% incidence in either group), underscoring differences in tolerability among the antipsychotics examined. These findings collectively supported the short-term use of blonanserin as a viable and well-tolerated alternative in the pharmacological management of schizophrenia.
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