TITLE

Antipsychotic-Induced Weight Gain in Chronic and First-Episode Psychotic Disorders: A Systematic Critical Reappraisal

AUTHOR(S)
Álvarez-Jiménez, Mario; González-Blanch, César; Crespo-Facorro, Benedicto; Hetrick, Sarah; Rodríguez-Sánchez, Jose Manuel; Pérez-Iglesias, Rocio; Vázquez-Barquero, Jose Luis
PUB. DATE
May 2008
SOURCE
CNS Drugs;2008, Vol. 22 Issue 7, p547
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Antipsychotic-induced weight gain is an important issue in the treatment of psychotic illnesses, and affects 80% of individuals being treated with antipsychotic drugs. However, the true dimension of weight gain and many accepted ‘facts’ in this area remain unclear as most research has been conducted in short-term trials and has included individuals receiving prolonged antipsychotic treatment. This review aims to systematically and critically review the evidence on weight gain induced by the two leading second-generation antipsychotics (olanzapine and risperidone) and the most widely researched first-generation antipsychotic (haloperidol) in patients with chronic and first-episode psychotic disorders. Weight gain was 3- to 4-fold greater in studies that included young patients with limited previous exposure to antipsychotic agents in both short-term studies (7. 1–9. 2 kg for olanzapine, 4. 0–5. 6 kg for risperidone and 2. 6–3. 8 kg for haloperidol vs 1. 8–5. 4 kg, 1. 0–2. 3 kg and 0. 01–1. 4 kg, respectively, in studies that included patients with chronic psychotic disorders) and long-term trials (10. 2–15. 4 kg for olanzapine, 6. 6–8. 9 kg for risperidone and 4. 0–9. 7 kg for haloperidol vs 2. 0–6. 2 kg, 0. 4–3. 9 kg and −0. 7 to 0. 4 kg, respectively). The same disparity was observed regarding the proportion of patients increasing their baseline weight by ≥7% (the cut-off for clinically significant weight gain). Recent studies carried out in young patients with first-episode psychosis (FEP), along with methodological artefacts in studies of chronic populations, suggest that the magnitude of weight gain reported by much of the literature could in fact be an underestimation of the true magnitude of this adverse effect. Although antipsychotics present idiosyncratic patterns of weight gain, they may also generate similar absolute gains.
ACCESSION #
32686415

 

Related Articles

  • Pharmacologic and nonpharmacologic strategies for weight gain and metabolic disturbance in patients treated with antipsychotic medications. Faulkner, Guy; Cohn, Tony A. // Canadian Journal of Psychiatry;Jul2006, Vol. 51 Issue 8, p502 

    Objectives: To provide an overview of pharmacologic and nonpharmacologic strategies for antipsychotic-associated weight gain and metabolic disturbance, to identify important areas for future research, and to make practice recommendations based on current knowledge.Methods:...

  • The promise of new drugs for schizophrenia treatment. Tamminga, C. A.; Tamminga, Ca // Canadian Journal of Psychiatry;Apr1997, Vol. 42 Issue 3, p265 

    Objective: To present aspects of preclinical and clinical pharmacology of new antipsychotic drugs and to emphasize those preclinical drug characteristics which might predict desirable clinical actions.Method: Review of the relevant literature and publicly presented...

  • Treatment of Weight Gain with Fluoxetine in Olanzapine-Treated Schizophrenic Outpatients. Bustillo, Juan R.; Lauriello, John; Parker, Katherine; Hammond, Roger; Rowland, Laura; Bogenschutz, Michael; Keith, Samuel // Neuropsychopharmacology;Mar2003, Vol. 28 Issue 3, p527 

    Significant weight gain is a side effect associated with olanzapine treatment in some patients. We investigated the efficacy of high-dose fluoxetine as a weight-reducing agent for patients who develop early weight gain with olanzapine treatment. Patients that gained ≥3% of their baseline...

  • Future management options. Barker, Andy; Benbow, Susan // Pulse;4/26/2004, Vol. 64 Issue 17, p46 

    Discusses management options for behavioral and psychiatric symptoms in dementia in elder patients in Great Britain. Management of older patients already taking olanzapine or risperidone; Treatment of people who have dementia and psychosis, such as paranoid delusions.

  • The potential role of appetite in predicting weight changes during treatment with olanzapine. Case, Michael; Treuer, Tamas; Karagianis, Jamie; Hoffmann, Vicki Poole // BMC Psychiatry;2010, Vol. 10, p72 

    Background: Clinically significant weight gain has been reported during treatment with atypical antipsychotics. It has been suggested that weight changes in patients treated with olanzapine may be associated with increased appetite. Methods: Data were used from adult patients for whom both...

  • Time Course of the Antipsychotic Effect and the Underlying Behavioral Mechanisms. Li, Ming; Fletcher, Paul J.; Kapur, Shitij // Neuropsychopharmacology;Feb2007, Vol. 32 Issue 2, p263 

    Antipsychotic drugs work for patients only when given repeatedly. The overall temporal pattern of symptom improvement is not clear. Some recent data question the traditional ‘delayed-onset’ hypothesis and suggest that the onset of antipsychotic response may be relatively early, and...

  • Dropout rates with olanzapine or risperidone: a multi-centre observational study. Pelagotti, F.; Santarlasci, B.; Vacca, F.; Trippoli, S.; Messori, A. // European Journal of Clinical Pharmacology;Feb2004, Vol. 59 Issue 12, p905 

    Objective. In patients with schizophrenia, risperidone and olanzapine are the two most commonly used atypical anti-psychotics. A recent meta-analysis based on randomized trials suggests that, in the long term, olanzapine can have a lower frequency of treatment discontinuation (or dropout) in...

  • Which atypical antipsychotic most costly in bipolar disorder?  // PharmacoEconomics & Outcomes News;6/4/2005, Issue 479, p4 

    Discusses research being done on mental health resources used by patients with bipolar disorder treated with risperidone, olanzapine, or quetiapine. Reference to a study by F. Gianfrancesco et al, published in the 2005 issue of the "Journal of Managed Care Pharmacy"; Advantages of olanzapine...

  • Quetiapine improves psychotic symptoms and cognition in Parkinson's disease. Jorge L. Juncos; Vicki J. Roberts; Marian L. Evatt; Rita D. Jewart; Colleen D. Wood; Larry S. Potter; Hann-Chang Jou; Paul P. Yeung // Movement Disorders;Jan2004, Vol. 19 Issue 1, p29 

    Twenty-nine elderly patients who failed treatment with clozapine, risperidone, or olanzapine entered this 24-week, single-center, open-label trial to assess the efficacy of quetiapine (12.5–400 mg/day) for psychosis in patients with Parkinson's disease (PD). Psychiatric, motor, and cognitive...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

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

Try another library?
Sign out of this library

Other Topics