Impact of low‐dose quetiapine‐use on glycosylated hemoglobin, triglyceride and cholesterol levels

Støvring, Henrik; Andersen, Kjeld; Correll, Christoph U.; Hallas, Jesper

doi:10.1111/acps.13515

Cited by 10 publications

(9 citation statements)

References 36 publications

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“…Regarding metabolic side effects, considering the dosage of quetiapine in our hospital (at the time of discharge, 13 of 14 patients were under 50 mg/day), the effect of multiple receptor blockade with quetiapine may not be significant. 10,11 BZD/non-BZD is a risk factor for falls, cognitive impairment, and delirium. [12][13][14] It is reported that BZD/non-BZD could cause dependence within months, even with regular doses.…”

Section: Discussionmentioning

confidence: 99%

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Reducing the use of psychotropics in a convalescent rehabilitation ward

Uematsu,

Tomita,

Obara

et al. 2023

Neuropsychopharm Rep

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AimsMany patients who are transferred to the convalescent rehabilitation ward of Kawasaki Kokoro Hospital (hereinafter, our hospital) are on psychotropics prescribed for delirium by their physicians at acute care hospitals. In this study, psychiatrists and pharmacists collaborated with rehabilitation physicians to reduce the use of psychotropics.MethodsThe basic information and psychotropics prescription statuses of 88 patients discharged from the convalescent rehabilitation ward of our hospital between April 1, 2021 and March 31, 2022 were derived from their medical records.ResultsAt admission, psychotropics were prescribed to 55 patients and the number of prescribed drugs was 2 (median). At discharge, psychotropics were prescribed to 41 patients and the number of prescribed drugs was 1 (median), showing a significant decrease (p < 0.05). Compared with those at admission, prescribed psychotropic doses at discharge were significantly higher for lemborexant but significantly lower for antipsychotics, benzodiazepine/nonbenzodiazepine hypnotics, antidepressants, suvorexant, ramelteon, and sodium valproate (p < 0.05).ConclusionsThese results suggest that it may be possible to reduce the types and doses of psychotropics prescribed at acute care hospitals in convalescent rehabilitation wards. However, further investigation is needed because the number of patients in this study was limited, and selection bias due to different patient characteristics cannot be ruled out.

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Section: Discussionmentioning

confidence: 99%

“…Therefore, reducing the dosage was difficult. Regarding metabolic side effects, considering the dosage of quetiapine in our hospital (at the time of discharge, 13 of 14 patients were under 50 mg/day), the effect of multiple receptor blockade with quetiapine may not be significant 10,11 …”

Section: Discussionmentioning

confidence: 99%

Reducing the use of psychotropics in a convalescent rehabilitation ward

Uematsu,

Tomita,

Obara

et al. 2023

Neuropsychopharm Rep

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“…The association of quetiapine with weight gain is also well-known, with novel data warning that even low-dose quetiapine is associated with this adverse effect (Hojlund et al 2023 ). This appears particularly relevant as low-dose quetiapine is frequently prescribed as an add-on drug targeting secondary symptoms such as insomnia and agitation in a transdiagnostic fashion (de Bardeci et al 2023 ; Pringsheim and Gardner 2014 ).…”

Section: Discussionmentioning

confidence: 99%

Controversies regarding lithium-associated weight gain: case–control study of real-world drug safety data

Greil,

de Bardeci,

Müller-Oerlinghausen

et al. 2023

Int J Bipolar Disord

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Background The impact of long-term lithium treatment on weight gain has been a controversial topic with conflicting evidence. We aim to assess reporting of weight gain associated with lithium and other mood stabilizers compared to lamotrigine which is considered free of metabolic adverse drug reactions (ADRs). Methods We conducted a case/non-case pharmacovigilance study using data from the AMSP project (German: “Arzneimittelsicherheit in der Psychiatrie”; i.e., Drug Safety in Psychiatry), which collects data on ADRs from patients treated in psychiatric hospitals in Germany, Austria, and Switzerland. We performed a disproportionality analysis of reports of weight gain (> 10% of baseline body weight) calculating reporting odds ratio (ROR). We compared aripiprazole, carbamazepine, lithium, olanzapine, quetiapine, risperidone, and valproate to lamotrigine. Additional analyses related to different mood stabilizers as reference medication were performed. We also assessed sex and age distributions of weight-gain reports. Results We identified a total of 527 cases of severe drug-induced weight gain representing 7.4% of all severe ADRs. The ROR for lithium was 2.1 (95%CI 0.9–5.1, p > 0.05), which did not reach statistical significance. Statistically significant disproportionate reporting of weight gain was reported for olanzapine (ROR: 11.5, 95%CI 4.7–28.3, p < 0.001), quetiapine (ROR: 3.4, 95%CI 1.3–8.4, p < 0.01), and valproate (ROR: 2.4, 95%CI 1.1–5.0, p = 0.03) compared to lamotrigine. Severe weight gain was more prevalent in non-elderly (< 65 years) than in elderly patients, with an ROR of 7.6 (p < 0.01) in those treated with lithium, and an ROR of 14.7 (p < 0.01) in those not treated with lithium. Conclusions Our findings suggest that lithium is associated with more reports of severe weight gain than lamotrigine, although this difference did not reach statistical significance. However, lithium use led to fewer reports of severe weight gain than some alternative drugs for long-term medication (olanzapine, quetiapine, and valproate), which is consistent with recent studies. Monitoring of weight gain and metabolic parameters remains essential with lithium and its alternatives.

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“…The association of quetiapine with weight gain is also well-known, with novel data warning that even lowdose quetiapine is associated with this adverse effect (Hojlund et al, 2023). This appears particularly relevant as low-dose quetiapine is frequently prescribed as an add-on drug targeting secondary symptoms such as insomnia and agitation in a transdiagnostic fashion (de Bardeci et al, 2023; Pringsheim and Gardner, 2014).…”

Section: Discussionmentioning

confidence: 99%

Controversies regarding Lithium-associated weight gain: Case-control study of real-world drug safety data

Greil,

Bardeci,

Müller-Oerlinghausen

et al. 2023

Preprint

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Background The impact of long-term lithium treatment on weight gain has been a controversial topic with conflicting evidence. We aim to assess reporting of weight gain associated with lithium and other mood stabilizers compared to lamotrigine which is considered free of metabolic adverse drug reactions (ADRs).Methods We conducted a case/non-case pharmacovigilance study using data from the AMSP project (German: "Arzneimittelsicherheit in der Psychiatrie"; i.e., Drug Safety in Psychiatry), which collects data on ADRs from patients treated in psychiatric hospitals in Germany, Austria, and Switzerland. We performed a disproportionality analysis of reports of weight gain (> 10% of baseline body weight) calculating reporting odds ratio (ROR). We compared aripiprazole, carbamazepine, lithium, olanzapine, quetiapine, risperidone, and valproate to lamotrigine. Additional analyses related to different mood stabilizers as reference medication were performed. We also assessed sex and age distributions of weight-gain reports.Results We identified a total of 527 cases of severe drug-induced weight gain representing 7.4% of all severe ADRs. The ROR for lithium was 2.1 (95%CI: 0.9–5.1, p > 0.05), which did not reach statistical significance. Statistically significant disproportionate reporting of weight gain was reported for olanzapine (ROR: 11.5, 95%CI: 4.7–28.3, p < 0.001), quetiapine (ROR: 3.4, 95%CI: 1.3–8.4, p < 0.01), and valproate (ROR: 2.4, 95%CI: 1.1-5.0, p = 0.03) compared to lamotrigine. Severe weight gain was more prevalent in non-elderly (< 65 years) than in elderly patients, with an ROR of 7.6 (p < 0.01) in those treated with lithium, and an ROR of 14.7 (p < 0.01) in those not treated with lithium.Conclusions Our findings suggest that lithium is associated with more reports of severe weight gain than lamotrigine, although this difference did not reach statistical significance. However, lithium use led to fewer reports of severe weight gain than some alternative drugs for long-term medication (olanzapine, quetiapine, and valproate), which is consistent with recent studies. Monitoring of weight gain and metabolic parameters remains essential with lithium and its alternatives.

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Impact of low‐dose quetiapine‐use on glycosylated hemoglobin, triglyceride and cholesterol levels

Cited by 10 publications

References 36 publications

Reducing the use of psychotropics in a convalescent rehabilitation ward

Reducing the use of psychotropics in a convalescent rehabilitation ward

Controversies regarding lithium-associated weight gain: case–control study of real-world drug safety data

Controversies regarding Lithium-associated weight gain: Case-control study of real-world drug safety data

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