Cochrane · systematic review · CD006629
Antipsychotic switching for people with schizophrenia who have neuroleptic‐induced weight or metabolic problems
Mukundan, A, Faulkner, G, Cohn, T, et al. · Cochrane Database of Systematic Reviews · 2010 · Cochrane Library
SchizophreniaAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
16
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 5 · 23.8%Very low 4 · 19%Low 9 · 42.9%Moderate 3 · 14.3%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN compared to CONTINUATION ON PREVIOUS REGIMEN: 1a. DIFFERENT DEPOT from DEPOT‐medium term (3‐12 months) for people with schizophrenia who have neuroleptic‐induced weight or metabolic problems
Population: patients with people with schizophrenia who have neuroleptic‐induced weight or metabolic problems
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Weight: Body weight (kg) ‐ switching to haloperidol decanoate from fluphenazine decanoate SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1a. DIFFERENT DEPOT from DEPOT‐medium term (3‐12 months) | no estimate extracted | 1 study · 19 participants | Low |
Weight: BMI not improved SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1a. DIFFERENT DEPOT from DEPOT‐medium term (3‐12 months) | no estimate extracted | 0 studies · 3 participants | Ungraded |
Physiological measure: Metabolic syndrome SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1a. DIFFERENT DEPOT from DEPOT‐medium term (3‐12 months) | no estimate extracted | 0 studies · 3 participants | Ungraded |
Global state: Changing dose because of deterioration ‐ switching to haloperidol decanoate from fluphenazine decanoate SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1a. DIFFERENT DEPOT from DEPOT‐medium term (3‐12 months) | RR 0.18 [0.01, 3.35] | 1 study · 19 participants | Low |
Mental state: Deteriorated ‐ switching to haloperidol decanoate from fluphenazine decanoate SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1a. DIFFERENT DEPOT from DEPOT‐medium term (3‐12 months) | RR 0.18 [0.01, 3.35] | 1 study · 19 participants | Low |
Adverse effects: serious SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1a. DIFFERENT DEPOT from DEPOT‐medium term (3‐12 months) | no estimate extracted | 0 studies · 3 participants | Ungraded |
Satisfaction with care: Loss to SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1a. DIFFERENT DEPOT from DEPOT‐medium term (3‐12 months) | RR 4.55 [0.25, 83.7] | 1 study · 19 participants | Very low Downgraded: imprecision |
SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN compared to CONTINUATION ON PREVIOUS REGIMEN: 1b. NEW ATYPICAL from OLANZAPINE ‐ medium term (3‐12 months) for people with schizophrenia who have neuroleptic‐induced weight or metabolic problems
Population: patients with people with schizophrenia who have neuroleptic‐induced weight or metabolic problems
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Weight: 1. Body weight (kg) SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1b. NEW ATYPICAL from OLANZAPINE ‐ medium term (3‐12 months) | no estimate extracted | 2 studies · 287 participants | Low Downgraded: imprecision |
Weight: 1. Body weight (kg) ‐ switching to aripiprazole SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1b. NEW ATYPICAL from OLANZAPINE ‐ medium term (3‐12 months) | no estimate extracted | 1 study · 158 participants | Low |
Weight: 2a. BMI ‐ Increase SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1b. NEW ATYPICAL from OLANZAPINE ‐ medium term (3‐12 months) | RR 0.28 [0.13, 0.57] | 1 study · 173 participants | Very low |
Physiological measures: 1c. Average fasting glucose change ‐ switching to aripiprazole and quetiapine SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1b. NEW ATYPICAL from OLANZAPINE ‐ medium term (3‐12 months) | no estimate extracted | 2 studies · 280 participants | Low |
Global state: Relapse SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1b. NEW ATYPICAL from OLANZAPINE ‐ medium term (3‐12 months) | RR 1.31 [0.55, 3.11] | 1 study · 133 participants | Low |
Adverse events: 1a. Serious adverse event ‐ switching to aripiprazole SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1b. NEW ATYPICAL from OLANZAPINE ‐ medium term (3‐12 months) | RR 0.64 [0.24, 1.71] | 1 study · 172 participants | Low |
Satisfaction with care: Loss to SWITCHING ‐ NEW ANTIPSYCHOTIC REGIMEN vs CONTINUATION ON PREVIOUS REGIMEN: 1b. NEW ATYPICAL from OLANZAPINE ‐ medium term (3‐12 months) | RR 1.4 [0.89, 2.21] | 1 study · 173 participants | Very low |
SWITCHING ‐ TECHNIQUES: TO ARIPIPRAZOLE from PREVIOUS REGIMEN ‐ THREE DIFFERENT TECHNIQUES ‐short term (up to 12 months) for people with schizophrenia who have neuroleptic‐induced weight or metabolic problems
Population: patients with people with schizophrenia who have neuroleptic‐induced weight or metabolic problems
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Weight: Gain‐more than or equal to 7% from baseline | RR 0.61 [0.15, 2.47] | 1 study · 207 participants | Moderate |
Weight: BMI not improved | no estimate extracted | 0 studies · 0 participants | Ungraded |
Physiological measure: Metabolic syndrome | no estimate extracted | 0 studies · 0 participants | Ungraded |
Global state: Average change (CGI‐I, high=good) | no estimate extracted | 1 study · 203 participants | Moderate |
Mental state: Average change (PANSS, high decline=good) | no estimate extracted | 1 study · 198 participants | Low Downgraded: imprecision |
Adverse events: Any event | RR 1 [0.91, 1.1] | 1 study · 207 participants | Moderate |
Satisfaction with care: Loss to | RR 4 [0.45, 35.19] | 1 study · 208 participants | Very low Downgraded: imprecision |