Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

43 questions · 44 findings · 7 reviews · Schizophrenia

No studies found 6 · 13.6%GRADE not reported 4 · 9.1%Very low 15 · 34.1%Low 14 · 31.8%Moderate 4 · 9.1%High 1 · 2.3%

Summary of findings table ‐ Antipsychotic dose reduction vs dose continuation

Global state ‐ number of participants with relapse/exacerbations of psychosis (combined time points) · patients with schizophrenia

Summary of findings table ‐ Antipsychotic dose reduction may leads to higher global state ‐ number of participants with relapse/exacerbations of… compared with dose continuation (low certainty).

1 finding from 1 review

Summary of findings table ‐ Antipsychotic dose reduction vs dose continuation

Leaving the study early ‐ for any reason ‐ overall acceptability (combined time points) · patients with schizophrenia

Summary of findings table ‐ Antipsychotic dose reduction probably leads to higher leaving the study early ‐ for any reason ‐ overall acceptability… compared with dose continuation (moderate certainty).

1 finding from 1 review

Summary of findings table ‐ Antipsychotic dose reduction vs dose continuation

Participants with at least some Side Effects · patients with schizophrenia

Summary of findings table ‐ Antipsychotic dose reduction showed no clear difference in adverse effects ‐ number of participants with at least 1 adverse… compared with dose continuation (moderate certainty).

1 finding from 1 review

Antipsychotic dose increase vs antipsychotic dose continuation

Adverse effects – leaving the study early due to adverse effects – overall tolerability – total · non response in schizophrenia

It is very uncertain whether antipsychotic dose increase changes leaving the study early: tolerability ‐ leaving early due to adverse… compared with antipsychotic dose continuation (very low certainty).

1 finding from 1 review

Antipsychotic dose increase vs antipsychotic dose continuation

Acceptability of treatment ‐ leaving the study early · non response in schizophrenia

Antipsychotic dose increase showed no clear difference in leaving the study early: acceptability ‐ leaving early due to any… compared with antipsychotic dose continuation (low certainty).

1 finding from 1 review

Antipsychotic dose increase vs antipsychotic dose continuation

Risk for at least one adverse event per patient · non response in schizophrenia

It is very uncertain whether antipsychotic dose increase changes adverse effects ‐ at least one adverse effect compared with antipsychotic dose continuation (very low certainty).

1 finding from 1 review

SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1b. NEW ATYPICAL from OLANZAPINE ‐ medium term (3‐12 months)

Weight: 2a. BMI ‐ Increase · patients with people with schizophrenia who have neuroleptic‐induced weight or metabolic problems

It is very uncertain whether SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN changes weight: 2a. BMI ‐ Increase compared with CONTINUATION ON PREVIOUS REGIMEN: 1b. NEW ATYPICAL from OLANZAPINE ‐… (very low certainty).

1 finding from 1 review

SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1b. NEW ATYPICAL from OLANZAPINE ‐ medium term (3‐12 months)

Physiological measures: 1c. Average fasting glucose change ‐ switching to aripiprazole and quetiapine · patients with people with schizophrenia who have neuroleptic‐induced weight or metabolic problems
1 finding from 1 review

SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1b. NEW ATYPICAL from OLANZAPINE ‐ medium term (3‐12 months)

Relapse · patients with people with schizophrenia who have neuroleptic‐induced weight or metabolic problems

SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN showed no clear difference in global state: Relapse compared with CONTINUATION ON PREVIOUS REGIMEN: 1b. NEW ATYPICAL from OLANZAPINE ‐… (low certainty).

1 finding from 1 review

SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1b. NEW ATYPICAL from OLANZAPINE ‐ medium term (3‐12 months)

Adverse events: 1a. Serious adverse event ‐ switching to aripiprazole · patients with people with schizophrenia who have neuroleptic‐induced weight or metabolic problems

SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN showed no clear difference in adverse events: 1a. Serious adverse event ‐ switching to aripiprazole compared with CONTINUATION ON PREVIOUS REGIMEN: 1b. NEW ATYPICAL from OLANZAPINE ‐… (low certainty).

1 finding from 1 review

SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1b. NEW ATYPICAL from OLANZAPINE ‐ medium term (3‐12 months)

Satisfaction with care: Loss to · patients with people with schizophrenia who have neuroleptic‐induced weight or metabolic problems

It is very uncertain whether SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN changes satisfaction with care: Loss to compared with CONTINUATION ON PREVIOUS REGIMEN: 1b. NEW ATYPICAL from OLANZAPINE ‐… (very low certainty).

1 finding from 1 review

SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1a. DIFFERENT DEPOT from DEPOT‐medium term (3‐12 months)

Weight: BMI not improved · patients with people with schizophrenia who have neuroleptic‐induced weight or metabolic problems
1 finding from 1 review

SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1a. DIFFERENT DEPOT from DEPOT‐medium term (3‐12 months)

Physiological measure: Metabolic syndrome · patients with people with schizophrenia who have neuroleptic‐induced weight or metabolic problems
1 finding from 1 review

SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1a. DIFFERENT DEPOT from DEPOT‐medium term (3‐12 months)

Global state: Changing dose because of deterioration ‐ switching to haloperidol decanoate from fluphenazine decanoate · patients with people with schizophrenia who have neuroleptic‐induced weight or metabolic problems

SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN showed no clear difference in global state: Changing dose because of deterioration ‐ switching to… compared with CONTINUATION ON PREVIOUS REGIMEN: 1a. DIFFERENT DEPOT from… (low certainty).

1 finding from 1 review

SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1a. DIFFERENT DEPOT from DEPOT‐medium term (3‐12 months)

Mental state: Deteriorated ‐ switching to haloperidol decanoate from fluphenazine decanoate · patients with people with schizophrenia who have neuroleptic‐induced weight or metabolic problems

SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN showed no clear difference in mental state: Deteriorated ‐ switching to haloperidol decanoate from… compared with CONTINUATION ON PREVIOUS REGIMEN: 1a. DIFFERENT DEPOT from… (low certainty).

1 finding from 1 review