Weight Gain and Metabolic Screening in Young People With Early Psychosis on Injectable Depot Antipsychotic Medication (Aripiprazole vs Paliperidone)

Abstract

Background: Long-acting injectable (LAI) antipsychotics are increasingly being prescribed to young people diagnosed with psychosis 1 and can assist with medication compliance 2 . It is often postulated that aripiprazole has the least impact on weight gain and metabolic effects relative to other antipsychotics 3 . However, studies in young people are rare, and head to head comparisons against other LAIs such as paliperidone are lacking. Aims: To examine long-term changes in weight and metabolic side effects of aripiprazole and paliperidone in LAI formulation in young people being treated in a community headspace Youth Early Psychosis Program, Perth Australia. Methods: A physical health nurse conducted regular metabolic screening. Weight, BMI and blood pressure were taken monthly during administration of the depot. Metabolic parameters were taken at baseline, and then every 3 months for 12 months. 59 Young people Participants 33 young people on aripiprazole, and 26 on paliperidone: No baseline group differences in age (mean = 21.2 years, SD = 2.1); clinical severity (mean BPRS score = 40.2, SD = 10.8) or total duration on the current LAI (mean = 381 days, SD = 255). Results * Both groups showed significant time-dependent increases in BMI, weight and waist circumference (p < 0.001) * At 12 months, patients on aripiprazole had significantly greater waist circumference (20 cm vs 5 cm, p < 0.01) and weight gain since baseline (10.1% vs 5.3%).* Aripiprazole was also associated with lower triglycerides and prolactin levels compared to paliperidone (p < 0.001).