Pharmacological interventions for prevention of weight gain in people with schizophrenia

Agarwal, Sri Mahavir; Stogios, Nicolette; Ahsan, Zohra; Lockwood, Jonathan; Duncan, Markus J.; Takeuchi, Hiroyoshi; Cohn, Tony; Taylor, Valerie H.; Remington, Gary; Faulkner, Guy; Hahn, Margaret

doi:10.1002/14651858.cd013337.pub2

Cited by 21 publications

(15 citation statements)

References 245 publications

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“…Similarly, a positive correlation has been established between body-mass index (BMI) and the severity of positive symptoms in drug-naïve FEP schizophrenia patients ( 88 ), and there is emerging evidence linking cognitive impairment in schizophrenia to metabolic dysfunction ( 89 ). Indeed, a recent meta-analysis highlighted that individuals with schizophrenia who also have MetS or diabetes mellitus tend to experience more severe cognitive deficits, and that there is a significant relationship between cognitive impairment in schizophrenia and the individual components of MetS (including hypertension, dyslipidemia, abdominal obesity and diabetes), suggesting that MetS may contribute to functional decline in these patients ( 90 ).…”

Section: Discussionmentioning

confidence: 99%

“…Metformin is often preferred for its tolerability and effectiveness ( 105 ). Indeed, a systematic review of 17 randomized controlled trials involving 1,388 participants, various medications, including metformin, H2 antagonists, and monoamine modulators, showed potential for preventing weight gain and BMI increase in people with limited certainty of evidence, while topiramate did not appear effective; however, further research is needed to confirm these findings ( 89 ). As always, careful consideration of efficacy, side effects, dosing, and contraindications is required when choosing medication.…”

Section: Discussionmentioning

confidence: 99%

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Shared and unique characteristics of metabolic syndrome in psychotic disorders: a review

Saccaro,

Aimo,

Panichella

et al. 2024

Front. Psychiatry

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IntroductionPeople with psychosis spectrum disorders (PSD) face an elevated risk of metabolic syndrome (MetS), which may reduce their life expectancy by nearly 20%. Pinpointing the shared and specific characteristics and clinical implications of MetS in PSD is crucial for designing interventions to reduce this risk, but an up-to-date review on MetS across the psychosis spectrum is lacking.MethodsThis narrative review fills this gap by examining the clinical literature on characteristics and implications of MetS in both distinct PSD and transdiagnostically, i.e., across traditional categorical diagnoses, with a focus on psychiatric and cardio-metabolic management.ResultsWe discuss common and specific characteristics of MetS in PSD, as well as factors contributing to MetS development in PSD patients, including unhealthy lifestyle factors, genetic predisposition, pro-inflammatory state, drugs consumption, antipsychotic medication, and psychotic symptoms. We highlight the importance of early identification and management of cardio-metabolic risk in PSD patients, as well as the existing gaps in the literature, for instance in the screening for MetS in younger PSD patients. We compare hypotheses-generating clinical associations and characteristics of MetS in different PSD, concluding by reviewing the existing recommendations and challenges in screening, monitoring, and managing MetS in PSD.ConclusionEarly identification and management of MetS are crucial to mitigate the long-term cardio-metabolic toll in PSD patients. Interventions should focus on healthy lifestyle and appropriate pharmacological and behavioral interventions. Further translational and clinical research is needed to develop targeted interventions and personalized treatment approaches for this vulnerable population, aiming at improving physical health and overall well-being.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Shared and unique characteristics of metabolic syndrome in psychotic disorders: a review

Saccaro,

Aimo,

Panichella

et al. 2024

Front. Psychiatry

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“… 64 The strong affinity of antipsychotics for 5-HT2C and H1 receptors is considered the primary cause of weight gain. 65 Besides, metabolic dysfunction is associated with higher insulin resistance and leptin production, both of which could significantly impact the SUA secretion system, resulting in an elevated level of SUA. 66 This study showed that antipsychotics had no significant effect on the prevalence of hyperuricemia.…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Hyperuricemia and the Association Between Hyperuricemia and Age in Patients with Psychiatric Disorders to a General Hospital: A Cross-Section Study

Yang,

Zhou,

Feng

et al. 2024

IJGM

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Purpose In clinical work, it has been found that the prevalence of hyperuricemia (HUA) is significantly higher in younger patients with psychiatric disorders, but there are few studies in this area. The present study aims to evaluate the prevalence of HUA and the relationship between the HUA and age in hospitalized patients with psychiatric disorders in the real world, and to provide a theoretical basis for clinical staff to pay attention to the metabolic indicators of younger patients and for future related studies. Methods This is a cross-sectional evaluation of a cohort of 1761 patients with psychiatric disorders of hospitalized. The categories of disorders designed for study included: Depression, Bipolar disorder, Schizophrenia, Anxiety, Obsessive-Compulsive disorder, Acute and transient psychotic disorder, Dissociative(conversion) disorders, Conduct disorders and Tic disorders. In addition, based on age, the participants are stratified into three groups. The authors used Kruskal–Wallis tests, chi-square tests, and multiple linear logistic regression to verify the relationship between HUA and age among hospitalized patients with psychiatric disorders. Results Overall, the estimated prevalence of HUA was 35.4%. The prevalence of HUA was significantly higher in individuals with 17 years and under compared to those with 45 years and above (P < 0.001). After adjusting for confounders, the prevalence of HUA remained higher at 17 years and under than at 45 years and above. Bipolar disorder can lead to an increased prevalence of HUA (P<0.05). Conclusion The prevalence of HUA was higher in hospitalized patients with psychiatric disorders, and the prevalence was inversely proportional to age.

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“…If more benign antipsychotics are an option, they should be preferred and, in case olanzapine is used, monitoring of cardiovascular risk factors as well as countermeasures to weight gain should be considered. Adjunctive metformin had the best evidence in a Cochrane review 33 , and lifestyle interventions such as diet and physical activity were found effective as well 34 .…”

Section: Discussionmentioning

confidence: 99%

Long‐term efficacy of antipsychotic drugs in initially acutely ill adults with schizophrenia: systematic review and network meta‐analysis

et al. 2023

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Most acute phase antipsychotic drug trials in schizophrenia last only a few weeks, but patients must usually take these drugs much longer. We examined the long-term efficacy of antipsychotic drugs in acutely ill patients using network meta-analysis. We searched the Cochrane Schizophrenia Group register up to March 6, 2022 for randomized, blinded trials of at least 6-month duration on all second-generation and 18 first-generation antipsychotics. The primary outcome was change in overall symptoms of schizophrenia; secondary outcomes were all-cause discontinuation; change in positive, negative and de pressive symptoms; quality of life, social functioning, weight gain, antiparkinson medication use, akathisia, serum prolactin level, QTc prolongation, and sedation. Confidence in the results was assessed by the CINeMA (Confidence in Network Meta-Analysis) framework. We included 45 studies with 11,238 participants. In terms of overall symptoms, olanzapine was on average more efficacious than ziprasidone (standardized mean difference, SMD=0.

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Pharmacological interventions for prevention of weight gain in people with schizophrenia

Cited by 21 publications

References 245 publications

Shared and unique characteristics of metabolic syndrome in psychotic disorders: a review

Shared and unique characteristics of metabolic syndrome in psychotic disorders: a review

The Prevalence of Hyperuricemia and the Association Between Hyperuricemia and Age in Patients with Psychiatric Disorders to a General Hospital: A Cross-Section Study

Long‐term efficacy of antipsychotic drugs in initially acutely ill adults with schizophrenia: systematic review and network meta‐analysis

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