Increased Appetite Plays a Key Role in Olanzapine-Induced Weight Gain in First-Episode Schizophrenia Patients

Abstract

Weight gain and metabolic disturbances, potentially influenced by increased appetite, are common effects of olanzapine treatment in patients with schizophrenia. In this study, we explored the association between olanzapine-induced weight gain and metabolic effects with increased appetite. Drug-naïve, first-episode schizophrenia patients were treated with olanzapine for 12 weeks. Assessments included time to increased appetite, body weight, body mass index, biochemical indicators of blood glucose and lipids, proportion of patients who gained more than 7% or 10% of their baseline weight upon treatment conclusion, patients who developed dyslipidemia, and Positive and Negative Syndrome Scale scores. In total, 33 patients with schizophrenia receiving olanzapine were enrolled and 31 completed the study. During the 12-week olanzapine treatment, 77.4% (24/31) patients had increased appetite with 58.1% (18/31) patients having increased appetite within the first 4 weeks. The mean time for increased appetite was 20.3 days. More patients in the increased appetite group increased their initial body weight by more than 7% after 12 weeks when compared to patients with unchanged appetite (22/24 [91.7%] vs. 3/7 [42.9%], p = 0.004). Earlier increased appetite led to more weight gain during the following month. Overall, 50% of patients in the increased appetite group had dyslipidemia after 12 weeks. Our results demonstrated that olanzapine induced significantly appetite increase in first-episode patients with schizophrenia and appetite increase played a key role in olanzapine-induced weight gain and dyslipidemia.

Olanzapine-Induced Activation of Hypothalamic Astrocytes and Toll-Like Receptor-4 Signaling via Endoplasmic Reticulum Stress Were Related to Olanzapine-Induced Weight Gain

“…In the present study, female rats were used since previous studies have reported that olanzapine treatment induced hyperphagia and weight gain in female rats but not in male rats (Baptista et al, 2002;Pouzet et al, 2003;Arjona et al, 2004). Moreover, clinical studies have shown that female patients were more likely to gain weight compared with males under olanzapine treatment (Bobes et al, 2003;Andersen et al, 2005;Saddichha et al, 2007;Huang et al, 2020). Therefore, in the present study, female rats were used to mimic olanzapineinduced weight gain in the clinic.…”

Olanzapine‐associated dose‐dependent alterations for weight and metabolic parameters in a prospective cohort

“…14,17 Data have also emphasized on behavioural mechanisms such as appetite changes following olanzapine initiation. 18,19 Regarding potential predictors of olanzapine-related weight gain, some evidence suggests that patients with larger early weight gain (EWG) (weight gain within 2 weeks after olanzapine initiation) may be at higher risk of olanzapine-induced weight gain. 20 The predictive role of EWG changes for the long-term weight gain was also reported in a 1-year longitudinal study of inpatients.…”

Anti-Inflammatory Diets and Schizophrenia

“…Antipsychotic drugs are prescribed as a main treatment that alleviates symptoms, prevents relapse of schizophrenia, and regulates the dopamine level to the normal. However, usage of antipsychotic drugs often has the side effects of increasing appetite and body weights by interfering ghrelin and leptin, so disturbance of dopaminergic neurotransmission may change food intake and increase body weight in schizophrenia population [ 9 10 11 ]. Also, schizophrenia patients had poor dietary patterns with more saturated fats, sugar and alcohol as well as less intakes of fish, vegetables, and fruits, which may be related to impaired cognitive function [ 12 13 ].…”