A potential role for adjunctive vitamin D therapy in the management of weight gain and metabolic side effects of second-generation antipsychotics

Abstract

, "A potential role for adjunctive vitamin D therapy in the management of weight gain and metabolic side effects of second-generation antipsychotics" (2011 AbstractSecond-generation antipsychotic (SGA) medications introduced about 20 years ago are increasingly used to treat psychiatric illnesses in children and adolescents. There has been a fi ve-fold increase in the use of these medications in U.S. children and adolescents in the past decade. However, there has also been a parallel rise in the incidence of side effects associated with these medications, such as obesity, dyslipidemia, insulin resistance, and diabetes mellitus. Despite the severity of these complications and their fi nancial impact on the national healthcare budget, there is neither a clear understanding of the mechanisms contributing to these side effects nor the best ways to address them. Studies that examined lifestyle modifi cation and pharmaceutical agents have yielded mixed results. Therefore, clinical studies using agents, such as vitamin D, which are inexpensive, readily available, with low side effects profi le, and have mechanisms to counteract the metabolic side effects of SGA agents, are warranted. Vitamin D is a prohormone with skeletal and extraskeletal properties that could potentially reduce the severity of these metabolic side effects. Its role as an adjunctive therapy for the management of metabolic side effects of SGA agents has not been adequately studied. Effective strategies to curb these side effects will improve the overall health of youths with psychiatric illnesses who receive SGAs. Herein we present a pilot study on the use of vitamin D in patients on treatment with SGAs.

Adiposity and Cardiometabolic Risk in Children With and Without Antipsychotic Drug Treatment

“…The results of our sensitivity analysis for different cutoffs on high vs low Vitamin D level (median split, 20 ng/mL or 30 ng/mL) suggest that the strength of the relationship between DEXA fat and liver fat increases as the vitamin D levels decrease. These results warrant further research but they do support the strategy proposed by others (20,41) to supplement vitamin D-deficient patients receiving antipsychotic drug therapy.…”

“…Further, the evidence supporting treatment of low vitamin D level has been equivocal. In a small 8 week pilot and feasibility study in inpatient adolescents (n ϭ 12), 2000 IU Vitamin D daily was associated with an increase in serum vitamin D concentration, but was not associated with consistent changes in body weight (41). Similarly, a small, 8 week pilot study evaluating the effect of daily supplementation at 2000 IU in 19 schizophrenic adults treated with antipsychotics with low vitamin D levels showed a significant improvement in vitamin D level from baseline, but no change in anthropomorphic or fasting metabolic parameters (42).…”

Managing cardiovascular disease risk in patients treated with antipsychotics: a multidisciplinary approach

“…A recent trial found that melatonin was helpful in decreasing weight gain in bipolar patients with antipsychotic-induced weight gain 80. Vitamin D381 and omega 3 fatty acids have been proposed as possible therapies in the case of antipsychotic induced weight gain as well.…”

Dietary Adequacy of Vitamin D and Calcium among Inuit and Inuvialuit Women of Child-Bearing Age in Arctic Canada: A Growing Concern

“…Although the relationship is unclear, it has been hypothesized that obesity could be a cause or a result of inadequate vitamin D and calcium status [33]. Smoking has also been associated with vitamin D inadequacy; among women in a Swiss population, current smokers consumed significantly less vitamin D and calcium than women who never smoked [34].…”