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Changes in body weight and psychotropic drugs: a systematic synthesis of the literature.

Abstract

INTRODUCTION

Psychotropic medication use is associated with weight gain. While there are studies and reviews comparing weight gain for psychotropics within some classes, clinicians frequently use drugs from different classes to treat psychiatric disorders.

OBJECTIVE

To undertake a systematic review of all classes of psychotropics to provide an all encompassing evidence-based tool that would allow clinicians to determine the risks of weight gain in making both intra-class and interclass choices of psychotropics.

METHODOLOGY AND RESULTS

We developed a novel hierarchical search strategy that made use of systematic reviews that were already available. When such evidence was not available we went on to evaluate randomly controlled trials, followed by cohort and other clinical trials, narrative reviews, and, where necessary, clinical opinion and anecdotal evidence. The data from the publication with the highest level of evidence based on our hierarchical classification was presented. Recommendations from an expert panel supplemented the evidence used to rank these drugs within their respective classes. Approximately 9500 articles were identified in our literature search of which 666 citations were retrieved. We were able to rank most of the psychotropics based on the available evidence and recommendations from subject matter experts. There were few discrepancies between published evidence and the expert panel in ranking these drugs.

CONCLUSION

Potential for weight gain is an important consideration in choice of any psychotropic. This tool will help clinicians select psychotropics on a case-by-case basis in order to minimize the impact of weight gain when making both intra-class and interclass choices.

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  • Authors+Show Affiliations

    ,

    Weight Management Clinic, Ottawa Hospital, Ontario, Canada. bdent@ottawahospital.on.ca

    , , , , , ,

    Source

    PloS one 7:6 2012 pg e36889

    MeSH

    Body Weight
    Humans
    Psychotropic Drugs
    Weight Gain

    Pub Type(s)

    Journal Article
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    22719834

    Citation

    Dent, Robert, et al. "Changes in Body Weight and Psychotropic Drugs: a Systematic Synthesis of the Literature." PloS One, vol. 7, no. 6, 2012, pp. e36889.
    Dent R, Blackmore A, Peterson J, et al. Changes in body weight and psychotropic drugs: a systematic synthesis of the literature. PLoS ONE. 2012;7(6):e36889.
    Dent, R., Blackmore, A., Peterson, J., Habib, R., Kay, G. P., Gervais, A., ... Wells, G. (2012). Changes in body weight and psychotropic drugs: a systematic synthesis of the literature. PloS One, 7(6), pp. e36889. doi:10.1371/journal.pone.0036889.
    Dent R, et al. Changes in Body Weight and Psychotropic Drugs: a Systematic Synthesis of the Literature. PLoS ONE. 2012;7(6):e36889. PubMed PMID: 22719834.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Changes in body weight and psychotropic drugs: a systematic synthesis of the literature. AU - Dent,Robert, AU - Blackmore,Angelique, AU - Peterson,Joan, AU - Habib,Rami, AU - Kay,Gary Peter, AU - Gervais,Alan, AU - Taylor,Valerie, AU - Wells,George, Y1 - 2012/06/15/ PY - 2012/6/22/entrez PY - 2012/6/22/pubmed PY - 2012/12/14/medline SP - e36889 EP - e36889 JF - PloS one JO - PLoS ONE VL - 7 IS - 6 N2 - INTRODUCTION: Psychotropic medication use is associated with weight gain. While there are studies and reviews comparing weight gain for psychotropics within some classes, clinicians frequently use drugs from different classes to treat psychiatric disorders. OBJECTIVE: To undertake a systematic review of all classes of psychotropics to provide an all encompassing evidence-based tool that would allow clinicians to determine the risks of weight gain in making both intra-class and interclass choices of psychotropics. METHODOLOGY AND RESULTS: We developed a novel hierarchical search strategy that made use of systematic reviews that were already available. When such evidence was not available we went on to evaluate randomly controlled trials, followed by cohort and other clinical trials, narrative reviews, and, where necessary, clinical opinion and anecdotal evidence. The data from the publication with the highest level of evidence based on our hierarchical classification was presented. Recommendations from an expert panel supplemented the evidence used to rank these drugs within their respective classes. Approximately 9500 articles were identified in our literature search of which 666 citations were retrieved. We were able to rank most of the psychotropics based on the available evidence and recommendations from subject matter experts. There were few discrepancies between published evidence and the expert panel in ranking these drugs. CONCLUSION: Potential for weight gain is an important consideration in choice of any psychotropic. This tool will help clinicians select psychotropics on a case-by-case basis in order to minimize the impact of weight gain when making both intra-class and interclass choices. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/22719834/full_citation L2 - http://dx.plos.org/10.1371/journal.pone.0036889 DB - PRIME DP - Unbound Medicine ER -