Acute weight gain, gender, and therapeutic response to antipsychotics in the treatment of patients with schizophrenia

Ascher-Svanum, Haya; Stensland, Michael; Zhongyun Zhao; Kinon, Bruce J.
January 2005
BMC Psychiatry;2005, Vol. 5, p3
Academic Journal
Background: Previous research indicated that women are more vulnerable than men to adverse psychological consequences of weight gain. Other research has suggested that weight gain experienced during antipsychotic therapy may also psychologically impact women more negatively. This study assessed the impact of acute treatment-emergent weight gain on clinical and functional outcomes of patients with schizophrenia by patient gender and antipsychotic treatment (olanzapine or haloperidol). Methods: Data were drawn from the acute phase (first 6-weeks) of a double-blind randomized clinical trial of olanzapine versus haloperidol in the treatment of 1296 men and 700 women with schizophrenia-spectrum disorders. The associations between weight change and change in core schizophrenia symptoms, depressive symptoms, and functional status were examined post-hoc for men and women and for each medication group. Core schizophrenia symptoms (positive and negative) were measured with the Brief Psychiatric Rating Scale (BPRS), depressive symptoms with the BPRS Anxiety/Depression Scale and the Montgomery-Asberg Depression Rating Scale, and functional status with the mental and physical component scores on the Medical Outcome Survey-Short Form 36. Statistical analysis included methods that controlled for treatment duration. Results: Weight gain during 6-week treatment with olanzapine and haloperidol was significantly associated with improvements in core schizophrenia symptoms, depressive symptoms, mental functioning, and physical functioning for men and women alike. The conditional probability of clinical response (20% reduction in core schizophrenia symptom), given a clinically significant weight gain (at least 7% of baseline weight), showed that about half of the patients who lost weight responded to treatment, whereas three-quarters of the patients who had a clinically significant weight gain responded to treatment. The positive associations between therapeutic response and weight gain were similar for the olanzapine and haloperidol treatment groups. Improved outcomes were, however, more pronounced for the olanzapine-treated patients, and more olanzapine-treated patients gained weight. Conclusions: The findings of significant relationships between treatment-emergent weight gain and improvements in clinical and functional status at 6-weeks suggest that patients who have greater treatment-emergent weight gain are more likely to benefit from treatment with olanzapine or haloperidol regardless of gender.


Related Articles

  • Dopamine, Striatum, Antipsychotics, and Questions About Weight Gain. Kapur, Shitij; Reis Marques, Tiago; Marques, Tiago Reis // JAMA Psychiatry;Feb2016, Vol. 73 Issue 2, p107 

    The article discusses the safety of antipsychotics and its association with weight gain. The author provides insight on the therapeutic use of antipsychotics, the association of these drugs with weight gain during treatment, the implications of their complications, and their effects to patients...

  • Second-generation antipsychotics offer mixed results. Zablocki, Elaine // Managed Healthcare Executive;Jun2007, Vol. 17 Issue 6, p44 

    The article examines the effectiveness and side effects of second-generation antipsychotic drugs in treating chronic schizophrenia. Results of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study reveal that schizophrenics who utilized antipsychotic medications...

  • Lurasidone. Sanford, Mark // CNS Drugs;2013, Vol. 27 Issue 1, p67 

    This review focuses on the efficacy and tolerability of lurasidone, which is approved in the USA, Puerto Rico and Canada for the treatment of schizophrenia. In two placebo-controlled, phase II trials, lurasidone 40-120 mg/day was efficacious in reducing the acute symptoms of schizophrenia. In a...

  • Striatal Reward Activity and Antipsychotic-Associated Weight Change in Patients With Schizophrenia Undergoing Initial Treatment. Nielsen, Mette Ø.; Rostrup, Egill; Wulff, Sanne; Glenthøj, Birte; Ebdrup, Bjorn H.; Ebdrup, Bjørn H // JAMA Psychiatry;Feb2016, Vol. 73 Issue 2, p121 

    Importance: Weight gain is a common and serious adverse effect of antipsychotic treatment. A variable individual predisposition to development of metabolic disturbances calls for predictive biological markers.Objectives: To investigate whether attenuated striatal...

  • Long term outcome of treating schizophrenia. Turner, Trevor Howard // BMJ: British Medical Journal (International Edition);11/6/2004, Vol. 329 Issue 7474, p1058 

    Presents an editorial on the need for long term studies on the treatment of schizophrenia. Guidelines on treatment from the National Institute for Clinical Excellence which urge the use of antipsychotic drugs; Concerns that there are not enough long term studies of the new drugs to be sure of...

  • Clopixol.  // Royal Society of Medicine: Medicines;2002, p162 

    The article presents information on Clopixol, a proprietary, prescription-only preparation of the antipsychotic zuclopenthixol dihydrochloride, and can be used for the long-term maintenance of schizophrenia and other psychoses. It is available as tablets and a depot deep intramuscular injection...

  • Pharmacoeconomic Assessment of Olanzapine in the Treatment of Refractory Schizophrenia Based on a Pilot Clinical Study. Sacristan, J.A.; Gomez, J.C.; Martin, J.; Garcia-Bernardo, E.; Peralta, V.; Alvarez, E.; Gurpegui, M. // Clinical Drug Investigation;1998, Vol. 15 Issue 1, p29 

    The objective of this study was to assess the pharmacoeconomic impact of olanzapine in the treatment of schizophrenic patients resistant to conventional antipsychotic drugs. The study was an open-label, multicentre, 'mirror-image', pilot study. Resource utilisation during the 6 months prior to...

  • COMMENTARY. Vaz-Leal, Francisco J. // Evidence Based Medicine;Oct2008, Vol. 13 Issue 5, p146 

    The author reflects on the implementation of metformin plus lifestyle intervention (LSI) in patients with antipsychotic-associated weight gain. He presents a treatment comparison between patients who receive atypical antipsychotics (AAPs) and those who do not. He states low AAP doses with...

  • Amoxapine as an Atypical Antipsychotic: A Comparative Study Vs Risperidone. Apiquian, Rogelio; Fresan, Ana; Ulloa, Rosa-Elena; de la Fuente-Sandoval, Camilo; Herrera-Estrella, Miguel; Vazquez, Alejandra; Nicolini, Humberto; Kapur, Shitij // Neuropsychopharmacology;Dec2005, Vol. 30 Issue 12, p2236 

    Amoxapine is marketed as an antidepressant. However, its invitro profile, receptor occupancy and preclinical effects are very similar to atypical antipsychotics. Amoxapine has also shown efficacy as an atypical antipsychotic in open trials. The objective of this study was to compare the...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics