Non-pharmacological management of antipsychotic-induced weight gain: systematic review and meta-analysis of randomised controlled trials

Br J Psychiatry. 2008 Aug;193(2):101-7. doi: 10.1192/bjp.bp.107.042853.

Abstract

Background: Antipsychotic-induced weight gain is a major concern in the treatment of psychosis. The efficacy of non-pharmacological interventions as well as the optimal intervention approach for this side-effect remain unclear.

Aims: To determine the effectiveness of non-pharmacological interventions and specific treatment approaches to control antipsychotic-induced weight gain in patients with first-episode or chronic schizophrenia.

Method: Systematic review and meta-analysis of randomised controlled trials.

Results: Ten trials were included in the meta-analysis. Adjunctive non-pharmacological interventions, either individual or group interventions, or cognitive-behavioural therapy as well as nutritional counselling were effective in reducing or attenuating antipsychotic-induced weight gain compared with treatment as usual, with treatment effects maintained over follow-up.

Conclusions: Non-pharmacological weight-management interventions should be a priority, particularly during the early stages of antipsychotic treatment. Preventive approaches have the potential to be more effective, acceptable, cost-efficient and beneficial.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Antipsychotic Agents / adverse effects*
  • Humans
  • Obesity / chemically induced*
  • Obesity / therapy
  • Randomized Controlled Trials as Topic
  • Schizophrenia / drug therapy
  • Weight Gain*

Substances

  • Antipsychotic Agents