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Peer-reviewedCC BYSchizophrenia

East Asian herbal medicine as an adjunctive treatment for schizophrenia: a systematic review and meta-analysis

  • Yujin Choi1
  • Pyung-Wha Kim2
  • Chan-Young Kwon3
  • Min-Jae Kim3
  • Kyoung-Eun Lee4
  • Suha Lee5
  • Suyeon Hwang5
  • Ji-Won Kim6
  • Ji-Won Oh6
  • Hye-Li Jeon7
  • Yunna Kim8
  • Boram Lee2
1 more authors
  • Seung-Hun Cho8
8 affiliations
  1. 1NeuroGlymph Imaging and Modulation Center, Korea Institute of Oriental Medicine
  2. 2KM Science Research Division, Korea Institute of Oriental Medicine
  3. 3Department of Oriental Neuropsychiatry, College of Korean Medicine, Dong-eui University
  4. 4Department of Oriental Neuropsychiatry, College of Korean Medicine, Dongguk University
  5. 5Department of Korean Medicine, College of Korean Medicine, Kyung Hee University
  6. 6Department of Korean Medicine, College of Korean Medicine, Dong-eui University
  7. 7Department of Artificial Intelligence, Dong-eui University
  8. 8Department of Neuropsychiatry, College of Korean Medicine, Kyung Hee University Medical Center, Kyung Hee University
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Abstract

Background Herbal medicine is widely used as an adjunctive treatment for schizophrenia, but evidence remains limited. Aims To evaluate the effectiveness and safety of East Asian herbal medicine combined with antipsychotics in schizophrenia spectrum disorders. Methods Ten sources including MEDLINE, EMBASE and CENTRAL were searched up to January 2025 for randomised controlled trials comparing East Asian herbal medicine combined with antipsychotics versus antipsychotics alone. Primary outcome was the overall symptom scores (PANSS/BPRS). Secondary outcomes included adverse events, negative and positive symptom scores, response rates, social function, quality of life, recurrence, and adherence. Risk of bias was assessed using the Cochrane RoB 2, and evidence certainty using GRADE. Results 270 studies comprising 26,053 participants were included. East Asian herbal medicine combined with standard-dose antipsychotics improved overall symptom (SMD − 1.38, 95% CI − 1.60 to −1.17; 181 studies, 18,569 participants; low-certainty evidence) and reduced adverse events (RR 0.56, 95% CI 0.51–0.62; 92 studies, 8983 participants; low-certainty evidence) versus antipsychotics alone. East Asian herbal medicine combined with low-dose antipsychotics versus standard-dose antipsychotics showed symptom improvement (SMD − 0.92, 95% CI − 1.54– − 0.29; 25 studies, 1907 participants; low-certainty evidence) and fewer adverse events (RR 0.44, 95% CI 0.34–0.58; 6 studies, 450 participants; low-certainty evidence). Conclusion Low-certainty evidence suggests that East Asian herbal medicine as an adjunct to antipsychotics may improve symptoms and reduce adverse events in schizophrenia. However, most studies raised concerns regarding the risk of bias, and potential publication bias was suspected. Results require cautious interpretation and further high-quality studies are needed.

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Cite

BibTeXRIS
BibTeX
@article{choi2026east,
  title = {{East Asian herbal medicine as an adjunctive treatment for schizophrenia: a systematic review and meta-analysis}},
  author = {Yujin Choi and Pyung-Wha Kim and Chan-Young Kwon and Min-Jae Kim and Kyoung-Eun Lee and Suha Lee and Suyeon Hwang and Ji-Won Kim and Ji-Won Oh and Hye-Li Jeon and Yunna Kim and Boram Lee and Seung-Hun Cho},
  journal = {Schizophrenia},
  year = {2026},
  month = jul,
  doi = {10.1038/s41537-026-00781-8},
  url = {https://doi.org/10.1038/s41537-026-00781-8},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - East Asian herbal medicine as an adjunctive treatment for schizophrenia: a systematic review and meta-analysis
AU  - Yujin Choi
AU  - Pyung-Wha Kim
AU  - Chan-Young Kwon
AU  - Min-Jae Kim
AU  - Kyoung-Eun Lee
AU  - Suha Lee
AU  - Suyeon Hwang
AU  - Ji-Won Kim
AU  - Ji-Won Oh
AU  - Hye-Li Jeon
AU  - Yunna Kim
AU  - Boram Lee
AU  - Seung-Hun Cho
PY  - 2026
DA  - 2026/07/01
JO  - Schizophrenia
DO  - 10.1038/s41537-026-00781-8
UR  - https://doi.org/10.1038/s41537-026-00781-8
AB  - Background Herbal medicine is widely used as an adjunctive treatment for schizophrenia, but evidence remains limited. Aims To evaluate the effectiveness and safety of East Asian herbal medicine combined with antipsychotics in schizophrenia spectrum disorders. Methods Ten sources including MEDLINE, EMBASE and CENTRAL were searched up to January 2025 for randomised controlled trials comparing East Asian herbal medicine combined with antipsychotics versus antipsychotics alone. Primary outcome was the overall symptom scores (PANSS/BPRS). Secondary outcomes included adverse events, negative and positive symptom scores, response rates, social function, quality of life, recurrence, and adherence. Risk of bias was assessed using the Cochrane RoB 2, and evidence certainty using GRADE. Results 270 studies comprising 26,053 participants were included. East Asian herbal medicine combined with standard-dose antipsychotics improved overall symptom (SMD − 1.38, 95% CI − 1.60 to −1.17; 181 studies, 18,569 participants; low-certainty evidence) and reduced adverse events (RR 0.56, 95% CI 0.51–0.62; 92 studies, 8983 participants; low-certainty evidence) versus antipsychotics alone. East Asian herbal medicine combined with low-dose antipsychotics versus standard-dose antipsychotics showed symptom improvement (SMD − 0.92, 95% CI − 1.54– − 0.29; 25 studies, 1907 participants; low-certainty evidence) and fewer adverse events (RR 0.44, 95% CI 0.34–0.58; 6 studies, 450 participants; low-certainty evidence). Conclusion Low-certainty evidence suggests that East Asian herbal medicine as an adjunct to antipsychotics may improve symptoms and reduce adverse events in schizophrenia. However, most studies raised concerns regarding the risk of bias, and potential publication bias was suspected. Results require cautious interpretation and further high-quality studies are needed.
SN  - 2754-6993
ER  -