SynthesisEuropean journal of clinical pharmacology2015
Treatment of clozapine-associated weight gain: a systematic review.
Synthesis in European journal of clinical pharmacology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 4 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- EPA guidance on lifestyle interventions for adults with severe mental illness: A meta-review of the evidence.European psychiatry : the journal of the Association of European Psychiatrists · 2024Pooled it
- Metformin for neurocognitive dysfunction in schizophrenia: a systematic review.Frontiers in psychiatry · 2024Pooled it
- Long-acting injectable antipsychotics for early psychosis: A comprehensive systematic review.PloS one · 2022Pooled it
- Pooled it
- Microbes, mood, and metabolism/obesity: Pharmacological insights into the gut-obesity-depression triad.Cellular and molecular life sciences : CMLS · 2026Review
- Clozapine, relapse, and adverse events: a 10-year electronic cohort study in Canada.The British journal of psychiatry : the journal of mental science · 2024Article
- Using Cariprazine to Ameliorate Negative Symptoms and Metabolic Side Effects of Clozapine and Paliperidone - Clinical Cases.Neuropsychiatric disease and treatment · 2022Article
- A comparison of the metabolic side-effects of the second-generation antipsychotic drugs risperidone and paliperidone in animal models.PloS one · 2021Article
- Clozapine Management in Schizophrenia Inpatients: A 5-Year Prospective Observational Study of Its Safety and Tolerability Profile.Neuropsychiatric disease and treatment · 2021Article
- Practical Strategies Using Medical Cannabis to Reduce Harms Associated With Long Term Opioid Use in Chronic Pain.Frontiers in pharmacology · 2021Article
- A Focused Review of the Metabolic Side-Effects of Clozapine.Frontiers in endocrinology · 2021Review
- Differential Effects of Acute Treatment With Antipsychotic Drugs on Peripheral Catecholamines.Frontiers in psychiatry · 2020Article
- Characterization of mental health in cannabis dispensary users, using structured clinical interviews and standardized assessment instruments.BMC psychiatry · 2019Article
- Association between Serum Lipids and Antipsychotic Response in Schizophrenia.Current neuropharmacology · 2019Review
- A phenotypic Caenorhabditis elegans screen identifies a selective suppressor of antipsychotic-induced hyperphagia.Nature communications · 2018Article
- PharmGKB summary: clozapine pathway, pharmacokinetics.Pharmacogenetics and genomics · 2018Article
- Long-Term Evolution of Metabolic Status in Patients with Schizophrenia Stably Maintained on Second-Generation Antipsychotics.Psychiatry investigation · 2018Article
- Safety of antipsychotics for the treatment of schizophrenia: a focus on the adverse effects of clozapine.Therapeutic advances in drug safety · 2018Review
- Clozapine-Induced Cardiovascular Side Effects and Autonomic Dysfunction: A Systematic Review.Frontiers in neuroscience · 2018Article
- Topiramate and Metformin Are Effective Add-On Treatments in Controlling Antipsychotic-Induced Weight Gain: A Systematic Review and Network Meta-Analysis.Frontiers in pharmacology · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeClozapine is an antipsychotic drug with superior efficacy in treatment-resistant schizophrenia. Clozapine is associated with a low likelihood of extrapyramidal symptoms and other neurological side-effects but a high propensity to induce weight gain and general metabolic dysregulation. Various pharmacological and behavioral treatment approaches for reducing clozapine-associated weight gain exist in the literature; however, there are currently no clear clinical guidelines as to which method is preferred. The aim of the current review is to systematically summarize studies that have studied both pharmacological and non-pharmacological interventions to attenuate or reverse clozapine-associated weight gain.
methodsA systematic review of EMBASE and MEDLINE databases of all articles published prior to January 2014 was conducted. Seventeen studies were identified as meeting inclusion criteria and included in the review.
resultsAripiprazole, fluvoxamine, metformin, and topiramate appear to be beneficial; however, available data are limited to between one and three randomized controlled trials per intervention. Orlistat shows beneficial effects, but in males only. Behavioral and nutritional interventions also show modest effects on decreasing clozapine-associated weight gain, although only a small number of such studies exist.
conclusionsWhile a number of pharmacological interventions can produce modest weight loss, each may be associated with negative side effects, which should be considered before beginning treatment. Given the pressing need to improve cardiometabolic health in most clozapine-treated patients, substantially more research is needed to develop sound clinical practice guidelines for the treatment of clozapine-associated weight gain.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.