You will be presented with a collection of medical randomized controlled trial (RCT) reports addressing a shared clinical question -- for instance, the efficacy of a medical intervention on a disease or condition. Given the titles and abstracts of these reports, your task is to generate the conclusion of the systematic review article synthesizing the key findings. Your conclusion should be a few sentences long. In your response, include only the conclusion and no other text. The RCT reports are below.



Title 1:
The Effect of Ranitidine on Olanzapine-Induced Weight Gain
Abstract 1:
Induced weight gain is a disturbing side effect of Olanzapine that affects the quality of life in psychotic patients . The aim of this study was to assess the efficacy of Ranitidine in attenuating or preventing  Olanzapine-induced weight gain . A parallel 2-arm clinical trial was done on 52 patients with schizophrenia , schizoaffective and schizophreniform disorders who received Olanzapine for the first time . All these were first-episode admitted patients . They were r and omly allocated to receive either Ranitidine or placebo . The trend of body mass index ( BMI ) was compared between groups over 16-week course of treatment .  Mean weight was 62.3 ( SD : 9.6 ) kg at baseline . Thirty-three subjects ( 63.5 % ) had positive family history of obesity . The average BMI increment was 1.1 for Ranitidine group and 2.4 for the placebo group . The multivariate analysis showed this effect to be independent of sex , family history of obesity , and baseline BMI value . The longitudinal modeling after controlling for baseline values failed to show the whole trend slope to be different . Although the slight change in trend 's slope puts forward a hypothesis that combined use of Ranitidine and Olanzapine may attenuate the weight gain long run , this needs to be retested in future larger scale long-term studies . This trial is registered with I RCT .ir 201009112181N5


Title 2:
Efficacy of ranitidine in olanzapine-induced weight gain: a dose-response study.
Abstract 2:
AIM Weight gain has long been recognized as a side-effect of atypical antipsychotic drugs . Numerous new approaches have been tried for prevention of weight gain , the H2 blockers being one of them . The study was conducted with the aim to evaluate the efficacy of ranitidine in olanzapine-induced weight gain at two fixed doses of 150 and 300 mg day-1 . METHODS Seventy-five in patients with an ICD-10-DCR diagnosis of schizophrenia as their first episode were r and omized into three groups of 25 patients each , receiving 150 mg day-1 ranitidine , 300 mg day-1 ranitidine and third group receiving only olanzapine . Their weight and body mass index ( BMI ) were measured at baseline and at intervals of 4 and 8 weeks . RESULTS All patients were comparable with respect to their weight and BMI at baseline . When a change in the weight and BMI was assessed at 4 and 8 weeks from baseline , no significant difference was observed between the three groups . CONCLUSION Ranitidine at doses of 150 and 300 mg day-1 when combined with olanzapine was ineffective in attenuating olanzapine-induced weight gain . The likely reasons could be the use of low doses for a shorter period of time , or mechanisms other than H2 receptors might play an important role in weight gain


Title 3:
[Randomized, open label study on the use of ranitidine at different doses for the management of weight gain associated with olanzapine administration].
Abstract 3:
Potential weight gain must be taken into account in the patient 's comprehensive treatment approach when initiating  antipsychotic treatment with Olanzapine .  There are effective preventive and therapeutic pharmacological interventions to control this adverse effect . Not addressing this eventual treatment aspect of Olanzapine treatment may compromise the patient 's health and his/her compliance with the pharmacological treatment indicated in serious psychiatric conditions . The decision to use a molecule must be made taking into account its efficacy , efficiency and adverse effect profile . In this study , concomitant administration of Ranitidine prevented or corrected weight gain in 59.6 % of cases . Patients followed by 16 weeks had shown the following results : Olanzapine without Ranitidine , exhibited an average weight gain of 3.4 kilograms , ranging between -2.5 and + 16 kg . This implies an average increase of 1.19 in BMI for this group . Patients treated additionally with Ranitidine at doses of 300 mg , a 0.9 kilogram weight gain ranging between -4 and + 10.6 kg was observed , implying an average BMI change of 0.34 . In patients treated with Ranitidine at doses of 600 mg , the weight gain curve trended toward normalization with a 1.6 kilogram decrease , ranging between -15 and + 7 kilograms , accounting for a decrease of 0.6 points in BMI . While more extensive studies are required , our interest with this study is to demonstrate that we can count on a potentially simple and useful response for the treatment of weight gain associated with Olanzapine use . The risk/benefit ratio is a paradigm in the practice of medicine . In the case of Olanzapine , the scale clearly tips in favor of the latter , making it the drug of choice in the treatment of schizophrenia and other psychotic disorders


Title 4:
Attenuation of olanzapine-induced weight gain with reboxetine in patients with schizophrenia: a double-blind, placebo-controlled study.
Abstract 4:
OBJECTIVE Since increased norepinephrine availability may account for the weight-reducing effect of appetite suppressants , the authors hypothesized that the addition of the selective norepinephrine reuptake inhibitor reboxetine may prevent or attenuate olanzapine-induced  weight gain . METHOD Twenty-six patients hospitalized for first-episode DSM-IV schizophrenic disorder participated in the study . In addition to 6 weeks of treatment with olanzapine , 10 mg/day , patients were r and omly allocated in a double-blind design to receive either reboxetine , 4 mg/day , ( N=13 ) or placebo ( N=13 ) . RESULTS Ten patients in each group completed the 6-week trial . Patients given olanzapine and reboxetine demonstrated a significantly lower increase in body weight ( mean=2.5 kg , SD=2.7 ) than those given olanzapine and placebo ( mean=5.5 kg , SD=3.1 ) . Significantly fewer patients in the olanzapine/reboxetine group ( N=2 of 10 ) than in the olanzapine/placebo group ( N=7 of 10 ) gained at least 7 % of their initial weight , the cutoff for clinical ly significant weight gain . The addition of reboxetine to olanzapine treatment was safe and well tolerated by the patients . A between-group difference in the reduction of Hamilton depression scale scores was seen that favored the olanzapine/reboxetine group ( mean difference=-3.1 , SD=1.25 ) . CONCLUSIONS The selective norepinephrine reuptake inhibitor reboxetine may reduce  olanzapine-induced  weight gain  in schizophrenia patients , and activation of the adrenergic system may attenuate weight gain induced by atypical antipsychotic agents


Title 5:
Evaluating an individualized lifestyle and life skills intervention to prevent antipsychotic-induced weight gain in first-episode psychosis.
Abstract 5:
AIM Initiating antipsychotic medication frequently induces rapid , clinical ly significant weight gain . We aim ed to evaluate the effectiveness of a lifestyle and life skills intervention , delivered within 4 weeks of antipsychotic medication initiation , in attenuating weight gain in youth aged 14 - 25 years with first-episode psychosis ( FEP ) . METHODS We undertook a prospect i ve , controlled study in two early psychosis community services . Intervention participants ( n = 16 ) received a 12-week individualized intervention delivered by specialist clinical staff ( nurse , dietician and exercise physiologist ) and youth peer wellness coaches , in addition to st and ard care . A comparison group was recruited from a similar service and received st and ard care  ( n = 12 ) . RESULTS The intervention group experienced significantly less weight gain at 12 weeks compared to st and ard care ( 1.8 kg , 95 % CI -0.4 to 2.8 vs. 7.8 kg , 4.8 - 10.7 , P < 0.001 ) . Thirteen per cent ( 2/16 ) of the intervention group experienced clinical ly significant weight gain ( greater than 7 % of baseline weight ) , while 75 % ( 9/12 ) of the st and ard care group experienced this level of weight gain . Similar positive effects of the intervention were observed for waist circumference . CONCLUSIONS A lifestyle and life skills intervention delivered as part of st and ard care attenuated antipsychotic-induced weight gain in young people with FEP . The intervention was acceptable to the young people referred to the service . Such interventions may prevent the seeding of future disease risk and in the long-term help reduce the life expectancy gap for people living with serious mental illness
Compared with the control group , adjunctive ranitidine was associated with marginally significant reductions in BMI and body weight .
After removing an outlier study for BMI , the effect of ranitidine remained significant .
Adjunctive ranitidine outperformed the placebo in the negative symptom score of the Positive and Negative Syndrome Scale .
Although ranitidine was associated with less frequent drowsiness , other adverse events were similar between the two groups .
Adjunctive ranitidine appears to be an effective and safe option for reducing antipsychotic-induced weight gain and improving negative symptoms in patients with schizophrenia .