Effectiveness of Orlistat Versus Diet and Exercise for Weight Gain Associated With Antidepressant Use

Schwartz, Thomas L.; Jindal, Shefali; Simionescu, Mihai; Nihalani, Nikhil; Azhar, Nouman; Tirmazi, Syed; Hussein, Juhi

doi:10.1097/01.jcp.0000138777.71009.61

Cited by 8 publications

(4 citation statements)

References 10 publications

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“…As low level diet and exercise programmes seem to be as beneficial as drug treatment it is suggested that diet and exercise education continue to be frontline treatment for psychotropic drug‐induced obesity, but that pharmacological approaches should be considered if behavioural approaches fail (106). Reduction of medication dosages, which could be another approach, is not supported by literature as a positive correlation of dose and weight gain is only shown with some antipsychotic drugs.…”

Section: Resultsmentioning

confidence: 99%

Metabolic side effects of antipsychotic medication

Tschoner¹,

Engl²,

Laimer³

et al. 2007

International Journal of Clinical Practice

211

157

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The use of second-generation antipsychotics (SGAs) is associated with metabolic side effects including weight gain, diabetes mellitus and an atherogenic lipid profile. These adverse effects are not only the risk factors for cardiovascular disease, insulin resistance and diabetes mellitus leading to increased morbidity and mortality but may also impair the patient's adherence to treatment. SGAs in particular are associated with significant weight gain with clozapine and olanzapine carrying the highest risk, whereas newer agents, such as risperidone and aripiprazole, are considered to be less prone to cause weight gain. Consequently, a consensus development conference convened issuing recommendations on patient monitoring when treated with SGAs. The metabolic effects of antipsychotic drugs should be of concern when planning a patient's treatment strategy. Baseline screening and regular follow-up monitoring whose intervals should depend on the individual predisposition are advised. Possible therapeutical strategies for the management of drug-induced obesity include therapeutic approaches, such as life style change and pharmaceutical intervention. Drugs with a weight reducing effect become more important because of the lack of compliance with behavioural intervention. Topiramate, histamine-antagonists, dopaminergic- and serotoninergic agents have shown positive results in the management of psychotropic medication induced weight gain. However, further trials are required to support a specific therapeutical approach as well as studies to investigate the underlying mechanisms for future drug development.

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Section: Resultsmentioning

confidence: 99%

Metabolic side effects of antipsychotic medication

Tschoner¹,

Engl²,

Laimer³

et al. 2007

International Journal of Clinical Practice

211

157

View full text Add to dashboard Cite

show abstract

“…5 It is known that ritanserin, a 5-HT 2A antagonist, increases the amount of slow-wave sleep (SWS), one of the components of deep sleep, in both humans and rats. 6 Furthermore, in clinical trials, several agents that antagonize 5-HT 2A receptor activity, including ritanserin, 7 nefazodone, 8 and trazodone, 9 have been shown to reduce sleep disturbance in patients who suffer from a primary disorder other than sleep disturbance, for example, schizophrenia, depression, and anxiety. While these agents have potent activity at several G-protein-coupled receptors (GPCRs), preliminary (unpublished) information indicates that the selective 5-HT 2A antagonist M100907 ( Fig.…”

mentioning

confidence: 99%

4-Fluorosulfonylpiperidines: Selective 5-HT2A ligands for the treatment of insomnia

Fish

Gilligan

Humphries

et al. 2005

Bioorganic & Medicinal Chemistry Letters

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“…Case reports have also been published on the use of orlistat to treat the weight gain associated with antipsychotic drugs (Anghelescu et al, 2000;Hilger et al, 2002;Schwartz et al, 2004). Orlistat led to a mean weight loss of between 6.1% and 35%, without any significant alteration in the plasma concentration of any of the antipsychotics.…”

Section: Pharmacological Interventionsmentioning

confidence: 99%

Obesity - an epidemic of the twenty-first century: an update for psychiatrists

Holt¹

2005

J Psychopharmacol

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Obesity is a chronic relapsing condition associated with significant morbidity and premature mortality. The prevalence of obesity has increased dramatically over the last 20 years and continues to do so, primarily as a result of changes in dietary intake and exercise patterns. There are considerable challenges associated with the management of the obesity epidemic involving both public health policies and individual treatment. Management of the obese individual involves lifelong lifestyle change for all, drugs for some, and surgery for a few. Appropriate selection of patients and the setting of realistic goals are crucial to the success of any weight-reducing programme. The aim of obesity management is to reduce associated morbidity and mortality, not necessarily to restore normal body weight. While the current trends in obesity are depressing, a better understanding of the pathophysiology and treatment of the condition should allow the clinician to be more optimistic for the future.

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Effectiveness of Orlistat Versus Diet and Exercise for Weight Gain Associated With Antidepressant Use

Cited by 8 publications

References 10 publications

Metabolic side effects of antipsychotic medication

Metabolic side effects of antipsychotic medication

4-Fluorosulfonylpiperidines: Selective 5-HT2A ligands for the treatment of insomnia

Obesity - an epidemic of the twenty-first century: an update for psychiatrists

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