The British Journal of Psychiatry (2008) 193: 101-107. doi: 10.1192/bjp.bp.107.042853
© 2008 The Royal College of Psychiatrists
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REVIEW ARTICLE

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

Mario Álvarez-Jiménez, PhD

ORYGEN Research Centre, University of Melbourne, Australia, and University Hospital ‘Marqués de Valdecilla’, Department of Psychiatry, University of Cantabria School of Medicine, Santander, Spain

Sarah E. Hetrick, PhD

ORYGEN Research Centre, University of Melbourne, Australia

César González-Blanch, PhD

University Hospital ‘Marqués de Valdecilla’, Department of Psychiatry, University of Cantabria School of Medicine, Santander, Spain

John F. Gleeson, PhD

ORYGEN Research Centre, and Department of Psychiatry, University of Melbourne, and NorthWestern Mental Health Programme, Melbourne, Australia

Patrick D. McGorry, Md, PhD

ORYGEN Research Centre, University of Melbourne, Australia

Correspondence: Dr Mario Álvarez-Jiménez, ORYGEN Research Centre, 35 Poplar Road, Parkville 3054, Victoria, Melbourne, Australia. Email: malvarez{at}unimelb.edu.au

Declaration of interest

None. Funding detailed in Acknowledgments.

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.


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