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Review: metabolic side effects of second-generation antipsychotics

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Question

Question: To what extent do second-generation antipsychotics (SGAs) cause metabolic side effects?

Outcomes: Primary: weight change. Secondary: changes in glucose and cholesterol levels.

Methods

Design: Systematic review and meta-analysis.

Data sources: Cochrane schizophrenia group register (comprising literature from BIOSIS< CINAHL, EMBASE, LILACS, MEDLINE, PSYINDEX, PsychINFO, RUSSMED, Sociofile, dissertation abstracts, conference proceedings and findings from hand searching) up to May 2007. Supplementary search of MEDLINE and EMBASE to January 2009.

Study selection and analysis: The review focused on randomised blinded head-to-head trials of specified orally administered SGAs. Manufacturers of these drugs (amisulpride, aripiprazole, clozapine, olanzapine, quetiapine, risperidone, sertindole, ziprasidone and zotepine) were also contacted for further trials. Data extraction was undertaken by at least three reviewers. Meta-analysis was used to pool estimates of effect, and meta-regression was used to examine the effects of study duration, study sponsorship, gender, ethnicity and a variety of baseline physiological measures on differences between groups.

Main results

Forty-eight relevant trials were included; 6 of amisulpride, 5 of aripiprazole, 11 of clozapine, …

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