Table AOverview of treatment effects and SOE by intervention and major outcomesa

InterventionKQ 1: WeightKQ 2: Diabetes (HbA1c)KQ 3: LipidsbOverall CVD Risk and Other Outcomes
BehavioralSmall benefit (−3.1 kg)a
Moderate SOEa
Insufficient SOENo important effect from weight control interventions
Insufficient SOE
1 study assessed health-related quality of life and found no differences
Only 2 studies reported discontinuation due to adverse effects
Insufficient SOE
Peer or family supportNo studies
Insufficient SOE
No studies
Insufficient SOE
No studies
Insufficient SOE
No studies
Insufficient SOE
MetforminSmall benefit (−4.1 kg)a
Low SOEa
Insufficient SOENo studies
Insufficient SOE
Insufficient SOE for CVD risk
Topiramate, zonisamideSmall to moderate benefit (−5.1 kg)a
Low SOEa
Insufficient SOEPossible benefit with topiramate
Insufficient SOE
Insufficient SOE for CVD risk
AntihistamineNo benefita
Low SOEa
Insufficient SOESingle study did not suggest benefit
Insufficient SOE
Insufficient SOE for CVD risk
Other medicationsInsufficient SOEInsufficient SOENo study suggested possible benefit
Insufficient SOE
Insufficient SOE for CVD risk
Antipsychotic switching or adjunctive useLow SOE for small benefit (−2 to −3 kg) with switching to aripiprazole or adjunctive aripiprazolea
Insufficient SOE from single studies that found no effect with switching to quetiapine or parenteral olanzapine
Insufficient SOEPossible benefit with adjunctive or switching to aripiprazolea
Low SOEa
Insufficient SOE for CVD risk
Low SOE for possible higher rate of mental health worsening with switchinga
Multicomponent lifestyleInsufficient SOEInsufficient SOEInsufficient SOE2 studies suggested benefit for health-related quality of life
1 study reported no benefit on CVD risk score
Insufficient SOE

CVD = cardiovascular disease; KQ = Key Question; SOE = strength of evidence

a

Shaded cells highlight SOE ratings that are above insufficient.

b

No studies of lipid-focused interventions.

Shaded cells highlight SOE ratings that are above insufficient.

No studies of lipid-focused interventions.

From: Executive Summary

Cover of Interventions To Improve Cardiovascular Risk Factors in People With Serious Mental Illness
Interventions To Improve Cardiovascular Risk Factors in People With Serious Mental Illness [Internet].
Comparative Effectiveness Reviews, No. 105.
Gierisch JM, Nieuwsma JA, Bradford DW, et al.

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