Choi Yun-Jung
Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-Dong, Dongjak-Gu, Seoul 156-756, Republic of Korea.
ScientificWorldJournal. 2015;2015:970730. doi: 10.1155/2015/970730. Epub 2015 Jan 13.
This study was conducted to review systematically adjunctive treatments for weight reduction in patients with schizophrenia and compare efficacies of clinical trials through meta-analysis, so as to provide effective clinical guideline regarding weight control for patients taking atypical antipsychotics.
Candidate clinical trials were identified through searching the Cochrane Central Register of Controlled Trials, PubMed, and PsycINFO. Fourteen randomized clinical trials were included for systematic review and meta-analysis from 132 potential trials. The Comprehensive Meta-Analysis version 2 was used for meta-analysis.
Difference in means and significances from meta-analyses regarding weight control by adjunctive treatments showed that topiramate, aripiprazole, or sibutramine was more effective than metformin or reboxetine. Psychiatric evaluations did not show statistically significant changes between treatment groups and placebo groups except topiramate adjunctive treatments. Adverse effects regarding adjunctive therapies were tolerable and showed statistically no significances compared to control groups.
Though having several reports related to exacerbation of psychiatric symptoms, topiramate and aripiprazole are more efficacious than other medications in regard to weight reduction and less burden of critical adverse effects as well as being beneficial for clinical improvement.
本研究旨在系统回顾精神分裂症患者体重减轻的辅助治疗方法，并通过荟萃分析比较临床试验的疗效，以便为服用非典型抗精神病药物的患者提供有效的体重控制临床指南。
通过检索Cochrane对照试验中央注册库、PubMed和PsycINFO来确定候选临床试验。从132项潜在试验中纳入了14项随机临床试验进行系统评价和荟萃分析。使用综合荟萃分析2.0版进行荟萃分析。
辅助治疗体重控制的荟萃分析在均值差异和显著性方面表明，托吡酯、阿立哌唑或西布曲明比二甲双胍或瑞波西汀更有效。除托吡酯辅助治疗外，各治疗组与安慰剂组之间的精神科评估未显示出统计学上的显著变化。辅助治疗的不良反应是可耐受的，与对照组相比在统计学上无显著差异。
尽管有几份关于精神症状加重的报告，但托吡酯和阿立哌唑在减轻体重方面比其他药物更有效，严重不良反应负担更小，且有利于临床改善。
