Glucose and lipid disturbances after 1 year of antipsychotic treatment in a drug-naïve population

Pérez-Iglesias, Rocí­o; Mata, Ignacio; Pelayo-Terán, José María; Amado, J. A.; García‐Unzueta, María Teresa; Berja, Ana; Martínez-Garcia, Obdulia; Vázquez‐Barquero, José Luís; Crespo‐Facorro, Benedicto

doi:10.1016/j.schres.2008.09.028

Cited by 83 publications

(50 citation statements)

References 31 publications

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“…As previously reported in this cohort (Perez-Iglesias et al, 2009), the changes in lipid, insulin and leptin concentrations are significantly correlated with weight gain. The data suggest that interventions targeting weight gain may also prevent lipid and glycaemic abnormalities.…”

Section: Course Of Weight Gain and Metabolic Changessupporting

confidence: 87%

Course of weight gain and metabolic abnormalities in first treated episode of psychosis: the first year is a critical period for development of cardiovascular risk factors

Pérez-Iglesias

Martínez-Garcia

Pardo-García

et al. 2013

Int. J. Neuropsychopharm.

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107

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Data on the long-term metabolic side-effects associated with antipsychotics are scarce. Prospective longitudinal studies in medication-naive patients with a first episode of psychosis are a valuable source of information as they provide an assessment prior to the antipsychotic exposure and minimize the effect of potential confounding factors. The aim of this study was to assess the course of weight gain and the incidence of metabolic abnormalities during the first 3 yr of antipsychotic treatment. Data were collected from a cohort of 170 first-episode psychosis patients. They were randomly assigned to haloperidol (32%); olanzapine (32%) and risperidone (36%). The dose used was flexible. The initial antipsychotic treatment was changed when required, based on clinical response and tolerability. The results showed that the mean weight gain at 3 yr was 12.1 kg (s.d. = 10.7). It appeared to increase rapidly during the first year (85% of the total mean weight gain) and then stabilized gradually over time. Total cholesterol, LDL-cholesterol and triglyceride levels followed a similar trajectory with a significant increase only during the first year. No significant changes were detected in the mean values of glycaemic parameters. Two patients with a family history of diabetes developed diabetes type II. At short-term the factors positively associated with weight gain were lower body mass index, male gender and olanzapine treatment. At long-term, functional status and clinical response were the main predictors. The results of our study indicate that the first year of antipsychotic treatment is a critical period for weight gain and metabolic changes. Identification of weight gain patterns may help to inform studies that aim to prevent or mitigate the metabolic adverse events associated with antipsychotic therapy.

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Section: Course Of Weight Gain and Metabolic Changessupporting

confidence: 87%

Course of weight gain and metabolic abnormalities in first treated episode of psychosis: the first year is a critical period for development of cardiovascular risk factors

Pérez-Iglesias

Martínez-Garcia

Pardo-García

et al. 2013

Int. J. Neuropsychopharm.

Self Cite

107

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“…For example, many studies have found the increased HOMA-IR induced by chronic treatment of olanzapine, clozapine or risperidone was correlated with weight gain/adiposity. 58,77,80 Weight gain and adiposity were also found to be significantly correlated with changes in insulin sensitivity in patients following a 12 week treatment with olanzapine and risperidone. 59 Recently, Kim et al reported that body mass index contributed a quarter to a third of the variance in insulin resistance in olanzapine-treated patients.…”

Section: Indirect Effects Of Apd-induced Weight Gain and Obesity Vs Dmentioning

confidence: 93%

Effects of Antipsychotic Medications on Appetite, Weight, and Insulin Resistance

Deng¹

2013

Endocrinology and Metabolism Clinics of North America

144

100

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Although clozapine, olanzapine, and other atypical antipsychotic drugs (APDs) have fewer extrapyramidal side effects, they have serious metabolic side effects such as substantial weight gain, intra-abdominal obesity, and type 2 diabetes mellitus. Given that most patients with mental disorders face chronic, even life-long, treatment with APDs, the risks of weight gain/obesity and other metabolic symptoms are major considerations for APD maintenance treatment. This review focuses on the effects of APDs on weight gain, appetite, insulin resistance, and glucose dysregulation, and the relevant underlying mechanisms that may be help to prevent and treat metabolic side effects caused by APD therapy.

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“…Genetic linkage studies have identified multiple chromosomal regions, which are associated with both diabetes type 2 and schizophrenia [18,19 ]. Recently, several [17,[20][21][22], but not all of the studies [23,24 ], have demonstrated abnormal glucose metabolism among treatment-naive individuals with firstepisode psychosis. These patients have not been exposed to antipsychotics and, thus, the effect on weight and metabolic change as a result of treatment or lifestyle changes due to their mental illnesses is minimal.…”

Section: Recent Findingsmentioning

confidence: 99%

Metabolic syndrome with the atypical antipsychotics

Pramyothin

Khaodhiar

2010

Current Opinion in Endocrinology, Diabetes and Obesity

151

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Glucose and lipid disturbances after 1 year of antipsychotic treatment in a drug-naïve population

Cited by 83 publications

References 31 publications

Course of weight gain and metabolic abnormalities in first treated episode of psychosis: the first year is a critical period for development of cardiovascular risk factors

Course of weight gain and metabolic abnormalities in first treated episode of psychosis: the first year is a critical period for development of cardiovascular risk factors

Effects of Antipsychotic Medications on Appetite, Weight, and Insulin Resistance

Metabolic syndrome with the atypical antipsychotics

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