Risk of Weight Gain Associated with Antipsychotic Treatment: Results from the Canadian National Outcomes Measurement Study in Schizophrenia

McIntyre, Roger S.; Trakas, K; Lin, Daryl; Balshaw, Robert; Hwang, Pieway; Robinson, Kimberly A.; Eggleston, Andrew

doi:10.1177/070674370304801008

Cited by 54 publications

(30 citation statements)

References 14 publications

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“…Other than the change in antipsychotic medication, there were no other psychosocial or pharmacologic interventions that were part of the protocol, suggesting that changes in weight, BMI, and lipid levels are likely to be related to the change in antipsychotic medication. The change in weight and lipid levels associated with the three pre-switch medication regimens studied are consistent with the published literature on the rank order of relative risks these agents pose for weight gain and adverse effects on metabolic variables (Newcomer, 2005;Arato et al, 2002;Bobes et al, 2003;McIntyre et al, 2003).…”

Section: Discussionsupporting

confidence: 84%

Long-Term Changes in Weight and Plasma Lipids during Maintenance Treatment with Ziprasidone

Weiden

Newcomer

Loebel

et al. 2007

Neuropsychopharmacol

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To measure the long-term changes in weight and plasma lipids after switching antipsychotic treatment to ziprasidone, three 52-week, open-label extension studies of ziprasidone in outpatients (N ¼ 185) with schizophrenia or schizoaffective disorder successfully completing one of three, 6-week switch studies were carried out. Pre-switch treatment consisted of risperidone (n ¼ 43), olanzapine (n ¼ 71), or conventional antipsychotic agents (n ¼ 71). The maximum length of exposure to ziprasidone was 58 weeks. Nonfasting total cholesterol and triglyceride levels were obtained at baseline and at weeks 6, 19, 32, 45, and 58. Weight was measured at baseline and during each follow-up visit; height was recorded at baseline for the purpose of body mass index (BMI) calculation. Efficacy measures included the Positive and Negative Syndrome Scale and Clinical Global ImpressionFSeverity scale which were obtained at baseline and major follow-up points. Clinically significant sustained improvements in weight, BMI, total cholesterol, and triglyceride levels were observed among patients switched to ziprasidone from risperidone or olanzapine. Switching from conventional antipsychotics was not associated with significant changes in weight and lipid parameters. Mean reductions in weight from baseline to study endpoint were 9.8 kg (po0.001) and 6.9 kg (po0.005) for patients previously treated with olanzapine and risperidone, respectively. These findings demonstrate that switching from risperidone or olanzapine to ziprasidone is associated with sustained, clinically significant improvements in weight and plasma lipids.

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Section: Discussionsupporting

confidence: 84%

Long-Term Changes in Weight and Plasma Lipids during Maintenance Treatment with Ziprasidone

Weiden

Newcomer

Loebel

et al. 2007

Neuropsychopharmacol

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“…Olanzapine, clozapine (Allison et al, 1999;Wetterling, 2001), quetiapine (Borison et al, 1996;Arvanitis and Miller, 1997;Small et al, 1997;McIntyre et al, 2003) and risperidone (Claus et al, 1992;Peuskens, 1995;Emsley, 1999) treatments are associated with weight gain in human males and females. However the weight-gain associated with risperidone treatment is less than that associated with clozapine, olanzapine, or quetiapine (Allison et al, 1999;Taylor and McAskill, 2000;Wetterling, 2001).…”

Section: Discussionmentioning

confidence: 99%

Effects of Atypical Antipsychotic Drugs on Intralipid Intake and Cocaine-Induced Hyperactivity in Rats

Hartfield

Moore

Clifton

2005

Neuropsychopharmacol

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Clozapine and olanzapine have been shown to acutely stimulate consumption of a fat emulsion (Intralipid) by male Lister hooded rats. We initially investigated the extent of any sex difference in Intralipid hyperphagia associated with olanzapine treatment. We then examined the degree of Intralipid hyperphagia produced by a range of atypical antipsychotic drugs having different associations with human weight gain, and also determined their effects on cocaine-stimulated locomotor activity as a measure of functional dopamine antagonism in vivo. Olanzapine (0.1-1 mg/kg) stimulated Intralipid intake to an equal extent in male and female rats. Quetiapine (10 mg/kg) also stimulated Intralipid intake whereas ziprasidone (0.3-10 mg/kg) or risperidone (0.03-0.3 mg/kg) did not have this effect. All of the compounds, except quetiapine, reduced cocaine-stimulated locomotor activity but the relationship to the degree of Intralipid hyperphagia was variable. Since there was a positive relationship between Intralipid hyperphagia and the reported extent of human body weight gain, we conclude that Intralipid hyperphagia may have predictive value for this drug-associated side effect and is not related to the dopamine antagonist properties of these agents.

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“…[22][23][24][25][26][27][28] However, the contribution of other variables including first-generation antipsychotics (FGA), mood stabilisers and antidepressants in the development of metabolic disorders has also been recognised. [29][30][31][32][33][34] Unmodifiable risk factors (age, ethnicity, gender and family history) and modifiable ones (level of functioning, smoking history, dietary intake and obesity) in psychiatric patients have also been associated with metabolic disorders.…”

Section: Introductionmentioning

confidence: 99%

The prevalence of metabolic syndrome and its associated factors in long-term patients in a specialist psychiatric hospital in South Africa

et al. 2013

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Objective: The aims of this study were to determine the prevalence of metabolic disorders in long-term psychiatric patients, and the relationship between known risk factors and these metabolic disorders. Method: All psychiatric in-patients ≥18 years, who had been admitted ≥six months were invited to participate. Eighty-four patients participated. They were interviewed, examined, measured and blood tests conducted to determine several demographic and clinical variables including age, gender, weight, blood pressure and fasting blood glucose. Results: The prevalence of the metabolic disorders were: metabolic syndrome 32%, hypertension 32%, diabetes mellitus 8%, cholesterol dyslipidaemia 32%, triglyceride dyslipidaemia 29%, low density lipoprotein (LDL) dyslipidaemia 50%, overweight 37%, and obesity 24%. Black African and female patients were more likely to have metabolic syndrome. Female patients were more likely to have cholesterol dyslipidaemia and obesity. Hypertension was associated with age. Ninety-six percent of patients with dyslipidaemia were newly diagnosed during the study. Three out of the seven previously diagnosed diabetic patients had raised fasting blood glucose levels. Conclusion: The prevalence of metabolic syndrome falls towards the lower limits of the expected prevalence rate. Race and gender showed a moderate statistical association with metabolic syndrome. There is a lack of screening for dyslipidaemia in this setting. Diabetic patients should be referred to specialist diabetic clinics for better monitoring and control. developing countries. 20,21 Therefore, the first aim of the study was to determine the local prevalence of these metabolic disorders in long-term psychiatric patients.Many studies like CATIE have found a significant association between some second-generation antipsychotics (SGA) and weight gain, diabetes mellitus and dyslipidaemia. [22][23][24][25][26][27][28] However, the contribution of other variables including first-generation antipsychotics (FGA), mood stabilisers and antidepressants in the development of metabolic disorders has also been recognised. [29][30][31][32][33][34] Unmodifiable risk factors (age, ethnicity, gender and family history) and modifiable ones (level of functioning, smoking history, dietary intake and obesity) in psychiatric patients have also been associated with metabolic disorders. [35][36][37] Therefore, the second aim of the study was to determine whether these risk factors could be associated with metabolic disorders in long-term psychiatric patients.Although screening guidelines for these disorders have been recommended due to the significance of metabolic disorders in causing CVD, the guidelines are still not widely applied, even in developed countries. 38,39 Clinicians tend to rely on a patient's presentation of worrying symptoms/signs or in the case of inpatients, routine monthly blood pressure checking before investigating or treating these disorders. As a result, opportunities to detect and treat metabolic disorders may be missed. The...

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Risk of Weight Gain Associated with Antipsychotic Treatment: Results from the Canadian National Outcomes Measurement Study in Schizophrenia

Abstract: Clinicians are reminded to monitor anthropometric and metabolic parameters in all NAP-treated persons. Clinically significant differences in weight gain liability exist among the available NAPs.

Cited by 54 publications

References 14 publications

Long-Term Changes in Weight and Plasma Lipids during Maintenance Treatment with Ziprasidone

Long-Term Changes in Weight and Plasma Lipids during Maintenance Treatment with Ziprasidone

Effects of Atypical Antipsychotic Drugs on Intralipid Intake and Cocaine-Induced Hyperactivity in Rats

The prevalence of metabolic syndrome and its associated factors in long-term patients in a specialist psychiatric hospital in South Africa

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