Reply: Plasma Leptin and Antipsychotic-Induced Body Weight Gain

Melkersson proposed leptin dysregulation as a factor in the olanzapine-induced metabolic dysfunction. Their suggestion was based on the absence of the expected positive correlation between serum leptin levels and the BMI, and the loss of the sex-dependent difference in leptin levels, which are higher in women. Although subsequent studies did not confirm that proposal, few of them assessed basal leptin levels and corrected for body fat percentage. Along with these variables, we added a precise definition of participants out of the expected positive correlation in a large sample of schizophrenia patients. Sixty patients (26 women and 34 men) with severe schizophrenia undergoing chronic hospitalization and conventional antipsychotic treatment were switched to olanzapine (10-20 mg/day). We assessed at baseline, and at weeks 8 and 16 of treatment, the percentage of participants with abnormal correlation (out of the 95% confidence interval in the regression line) between leptin levels and the BMI, and the correlation between leptin and insulin, glucose, the insulin resistance index, c-reactive protein (CRP) and treatment response. Leptin levels were higher in women than in men (P<0.01). The positive correlation between leptin levels, BMI and percentage of fat were preserved. After olanzapine, 3.8% of women and 2.9-5.8% of men were out the 95% confidence interval, and the proportion was similar at baseline. Glucose, insulin, the insulin resistance index and the CRP levels significantly increased after olanzapine. The impact of olanzapine on leptin regulation appears discrete and limited to a small number of participants. Additional studies must clarify the features that render them to metabolic dysregulation.

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An evaluation of the metabolic effects of antipsychotic medications in patients suffering from psychiatric illness

2014

j app pharm sci

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Present study evaluates the effects of antipsychotic medications on metabolic parameters in patients suffering from psychiatric illness. The study was carried out at tertiary care teaching hospital, department of psychiatry after obtaining written informed consent from the patients. They were randomized into three groups -Group I (n=31) (haloperidol 10 mg/day, orally), Group II (n=34) (risperidone 4-6 mg/day, orally) and Group III (n=38) (olanzapine 10 mg/day, orally). Metabolic parameters [fasting blood sugar (FBS), post prandial blood sugar (PP2BS), glycosylated haemoglobin (HbA1c), serum cholesterol, triglyceride, low density lipoprotein (S.LDL) and high density lipoprotein (S.HDL)] were measured at the end of 3 and 6 months. Data was analysed using a suitable statistical tests. In group II significant changes (p<0.05) were observed in FBS, HBA1C, cholesterol, S.LDL and S.HDL while in group III significant changes (p<0.05) were observed in all the metabolic parameters at the end of 6 months. In group III, FBS, PP2BS, HbA1C, Serum cholesterol, triglyceride and S.LDL levels were increased 9.41%, 7.09%, 8%, 6.25%, 7.68% and 9.92% respectively, at the end of 6 months. Patients treated with haloperidol showed minimum changes in metabolic parameters at the end of 6 months. Olanzapine is associated with more disturbances in metabolic parameters as compared to risperidone and haloperidol.

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Reply: Plasma Leptin and Antipsychotic-Induced Body Weight Gain

Cited by 3 publications

References 4 publications

Frequency of abnormal correlation between leptin and the body mass index during first and second generation antipsychotic drug treatment

Frequency of abnormal correlation between leptin and the body mass index during first and second generation antipsychotic drug treatment

Similar frequency of abnormal correlation between serum leptin levels and BMI before and after olanzapine treatment in schizophrenia

An evaluation of the metabolic effects of antipsychotic medications in patients suffering from psychiatric illness

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