Sharpe Jenny-Kay, Hills Andrew P
General Health Services, The Park Centre for Mental Health, Wacol, Queensland, Australia.
Aust N Z J Psychiatry. 2003 Dec;37(6):705-9. doi: 10.1080/j.1440-1614.2003.01271.x.
The major aim of this paper is to review findings from weight management intervention studies to consider clozapine and/or olanzapine induced weight gain. A parallel aim is to summarize the challenges facing future research and provide an overview of best practice in the management of weight in mental health patients.
A systematic literature search was conducted using Medline, Cinahl and PsychINFO data bases and reference lists from relevant published articles. Five studies which reported weight control practices in patients taking atypical antipsychotic medications were located and reviewed.
The studies reviewed provide some important descriptive clinical insights; however, common shortcomings include small subject numbers and methodological drawbacks such as lack of a control group.
There is some evidence that weight gain associated with atypical antipsychotic medication can be ameliorated by lifestyle changes such as improved nutritional practices and increased physical activity. Lifestyle interventions for individuals with psychotic disorders may need to be adapted to be most effective; for example, using strategies to counter increased appetite and to enhance physical activity. Clinicians need to be vigilant and persistent in monitoring and intervening if weight gain occurs. A standardized screening tool and clinical pathway would help clinicians to target appropriate interventions for each person prescribed atypical antipsychotic medication.
本文的主要目的是回顾体重管理干预研究的结果，以探讨氯氮平和/或奥氮平所致体重增加的问题。另一个目的是总结未来研究面临的挑战，并概述心理健康患者体重管理的最佳实践。
使用Medline、Cinahl和PsychINFO数据库以及相关已发表文章的参考文献列表进行系统的文献检索。找到了五项报告服用非典型抗精神病药物患者体重控制情况的研究并进行了综述。
所综述的研究提供了一些重要的描述性临床见解；然而，常见的缺点包括样本量小以及方法学上的缺陷，如缺乏对照组。
有证据表明，非典型抗精神病药物所致体重增加可通过改善营养习惯和增加体育活动等生活方式改变得到改善。针对精神障碍患者的生活方式干预可能需要进行调整以达到最佳效果；例如，采用应对食欲增加和增强体育活动的策略。如果出现体重增加，临床医生需要保持警惕并持续进行监测和干预。标准化的筛查工具和临床路径将有助于临床医生针对每位服用非典型抗精神病药物的患者采取适当的干预措施。
