A Cochrane review included 3 studies with a total of 126 subjects. All studies compared antipsychotic drugs and DHEA from 25 mg to 200 mg per day versus antipsychotic drugs and placebo. All studies reported data for short-term follow-up (up to 12 weeks). Included people had the diagnosis of either schizophrenia or schizoaffective disorder.
Clinical Global Impression data were equivocal (n=27, 1 RCT, WMD -0.43 CI -0.9 to 0.1). Average total PANSS scores were not significantly different between the groups (n=82, 2 RCTs, WMD -4.16 CI -13.8 to 5.5). PANSS positive scores were equivocal (n=55, 1 RCT, WMD -1.00 CI -3.8 to 1.8). For negative symptoms binary SANS scale data favoured the DHEA plus antipsychotic group (n=30, 1 RCT, RR 0.23 CI 0.1 to 0.6, NNT 2 CI 2 to 3) but PANSS negative scores were not significantly different (n=55, 1 RCT, WMD -2.30 CI -6.4 to 1.8). About 17% of people left both groups early. St Hans Rating Scale data for extrapyramidal symptoms favoured the DHEA plus antipsychotic group (n=30, 1 RCT, WMD -5.00 CI -8.8 to -1.2) but akathisia ratings were equivocal (n=34, 1 RCT, RR 2.67 CI 0.3 to 23.1). Ratings of parkinsonian movement disorder differed within the same trial depending of the outcome scale used. Quality of life seemed unaffected by use of DHEA (n=55, 1 RCT, WMD 6.20 CI -1.4 to 13.8).
Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment), imprecise results (few patients and wide confidence intervals, limited study size for each comparison) and indirectness (only Israel-based studies, containing probably partially same patients).