Non-pharmacological management of antipsychotic-induced weight gain: systematic review and meta-analysis of randomised controlled trials.

BACKGROUND Antipsychotic-induced weight gain is a major concern in the treatment of psychosis. The efficacy of non-pharmacological interventions as well as the optimal intervention approach for this side-effect remain unclear. AIMS To determine the effectiveness of non-pharmacological interventions and specific treatment approaches to control antipsychotic-induced weight gain in patients with first-episode or chronic schizophrenia. METHOD Systematic review and meta-analysis of randomised controlled trials. RESULTS Ten trials were included in the meta-analysis. Adjunctive non-pharmacological interventions, either individual or group interventions, or cognitive-behavioural therapy as well as nutritional counselling were effective in reducing or attenuating antipsychotic-induced weight gain compared with treatment as usual, with treatment effects maintained over follow-up. CONCLUSIONS Non-pharmacological weight-management interventions should be a priority, particularly during the early stages of antipsychotic treatment. Preventive approaches have the potential to be more effective, acceptable, cost-efficient and beneficial.