Weight gain induced by haloperidol, risperidone and olanzapine after 1 year: Findings of a randomized clinical trial in a drug-naïve population

Pérez-Iglesias, Rocí­o; Crespo‐Facorro, Benedicto; Martínez-Garcia, Obdulia; Ramírez-Bonilla, María Luz; Álvarez‐Jiménez, Mario; Pelayo-Terán, José María; García‐Unzueta, María Teresa; Amado, J. A.; Vázquez‐Barquero, José Luís

doi:10.1016/j.schres.2007.10.022

Cited by 106 publications

(110 citation statements)

References 18 publications

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“…Our data on metabolic changes were in alignment with recent prospective studies in first-episode patents (Attux et al, 2007;Perez-Iglesias et al, 2008;Saddichha et al, 2007;Srisurapanont et al, 2007) and confirmed the differences between SGA in their liability to induce metabolic changes (Cohn and Sernyak, 2006;L'Italien et al, 2007;Newcomer, 2005;van Winkel et al, 2008).…”

Section: Discussionsupporting

confidence: 90%

Typical and atypical antipsychotics differentially affect long-term incidence rates of the metabolic syndrome in first-episode patients with schizophrenia: A retrospective chart review

Hert

Schreurs

Sweers

et al. 2008

Schizophrenia Research

221

118

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The presence of the metabolic syndrome (MetS) is an important risk factor for cardiovascular disease and diabetes. There are limited data on the prevalence of MetS in patients with schizophrenia at the onset of the disorder and specifically no data on patients treated in the era when only first-generation antipsychotics were available.Methods: Data from a historic cohort of consecutively admitted first-episode patients with schizophrenia treated with first-generation antipsychotics (FGAs) were compared with an age and sex matched series of consecutive first-episode patients treated only with second-generation antipsychotics (SGAs). Rates of MetS were compared at baseline and after on average 3 years of treatment exposure.Results: At first episode there was no difference in the prevalence of MetS between the historic and the current cohort. Rates of MetS increased over time in both groups, but patients started on SGAs had a three times higher incidence rate of MetS (Odds Ratio 3.6, CI 1.7-7.5). The average increase in weight and body mass index was twice as high in patients started on SGA. The difference between the FGA and SGA group was no longer significant when patients started on clozapine and olanzapine were excluded. Conclusion:Rates of MetS at the first episode of schizophrenia today are not different from those of patients 15 to 20 years ago. This finding counters the notion that the high rates of metabolic abnormalities in patients with schizophrenia currently reported are mainly due to lifestyle changes over time in the general population. Some SGAs have a significantly more negative impact on the incidence of MetS compared to FGAs in first-episode patients.

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Section: Discussionsupporting

confidence: 90%

Typical and atypical antipsychotics differentially affect long-term incidence rates of the metabolic syndrome in first-episode patients with schizophrenia: A retrospective chart review

Hert

Schreurs

Sweers

et al. 2008

Schizophrenia Research

221

118

View full text Add to dashboard Cite

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“…This magnitude of weight change is not usual with patients already using other antipsychotics previously, but such a higher rate of weight gain has already been observed in a drug-naive young population (mean age 26.7 years), in which 77.1% presented with SWG after 1 year [Perez-Iglesias et al 2008]. In that study the authors argued that the greater weight change was probably due to patients' characteristics (drug-naive young people with a low prevalence of obesity, 4%) and to good treatment compliance (low dropout rates, good family support), reflecting regular use of the drug.…”

Section: Discussionsupporting

confidence: 49%

Olanzapine, weight change and metabolic effects: a naturalistic 12-month follow up

Balbão

Hallak

Nunes

et al. 2013

Therapeutic Advances in Psychopharmacology

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Objective: Olanzapine is an atypical antipsychotic drug used to treat schizophrenia. Some of the adverse effects related to its use are obesity, hyperlipidemia, type 2 diabetes and hypertension, which may result in development of metabolic syndrome. This study aimed to investigate a possible increase in some anthropometric and biochemical parameters, and the existence of any correlation between them in Brazilian patients with schizophrenia treated with olanzapine in the mid term. Methods: Thirty subjects with schizophrenia were evaluated, 16 women and 14 men, aged between 18 and 47 years. All patients underwent blood collection and anthropometric measurements at four different times during 12 months of follow up; thus each patient was his or her own control. Results: Evaluation of some anthropometric measurements showed significant differences when comparing the mean values obtained in each of the different data collection times (p < 0.05). However, the biochemical indicators of development of metabolic syndrome measured in our study did not show the same rate of increment, with only the total cholesterol and glucose levels presenting statistically significant changes (p < 0.05), but without the same magnitude of weight change. Conclusion:We conclude that medium-term treatment with olanzapine promoted a substantial weight gain and increased visceral fat, while the metabolic profile did not show the same magnitude of change, suggesting a dissociation between weight gain and blood parameters, despite the severe weight gain observed among subjects evaluated.

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“…This Spanish study compared weight gain resulting from treatment with risperidone, haloperidol and olanzapine. In the first three months, olanzapine resulted in faster weight gain than risperidone or haloperidol, but after over 12 months, the amount of weight gain resulting from treatment with these drugs (8-10 kg) was not significantly different (Perez-Iglesias et al, 2008;Pérez-Iglesias et al, 2014). These data suggest that there is a shared general mechanism of weight gain induced by antipsychotics.…”

Section: Role Of Medication In Weight Gainmentioning

confidence: 77%

“…For example, following Nielsen and colleagues (Nielsen et al, 2016), we should try to study the predictive ability of striatal reward anticipation in patients with respect to weight gain, psychopathology and comorbid disorders over longer terms (6-18 months). Shorter-term studies would result in less variance and weight gain would plateau after about 12 months (Perez-Iglesias et al, 2008). The longer-term perspective may help us prevent comorbidities in our patients and design new and efficient treatments.…”

Section: Outlook: Possible New Therapies For Comorbid Obesitymentioning

confidence: 99%

Altered reward anticipation: Potential explanation for weight gain in schizophrenia?

Grimm

Kaiser

Plichta

et al. 2017

Neuroscience & Biobehavioral Reviews

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a b s t r a c tObesity and weight gain are severe complications of mental illness, especially schizophrenia. They result from changes in lifestyle and nutrition, side effects of medication and other, less well-understood factors. Recent studies suggest that obesity and weight gain are linked to psychopathology. Specifically, severe psychopathology is associated with greater weight dysregulation, typically weight gain. However, our knowledge about the neuroscientific basis of weight gain in schizophrenia is currently limited. We propose that altered reward anticipation, which in turn is related to striatal dopaminergic dysregulation, may explain why obesity is more prevalent in individuals with mental illness. We review evidence that reward anticipation and weight change are linked by a core deficit in dopaminergic striatal circuits. Several lines of evidence, running from animal studies to preclinical and clinical studies, suggest that striatal dopaminergic neurotransmission is a major hub for the regulation of eating behavior and that dopamine links eating behavior to other motivated behavior. From this perspective, the present review outlines a unifying perspective on dopaminergic reward anticipation as a theoretical frame to link weight gain, medication effects and psychopathology. We derive important but open empirical questions and present perspectives for new therapeutic concepts.

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Weight gain induced by haloperidol, risperidone and olanzapine after 1 year: Findings of a randomized clinical trial in a drug-naïve population

Cited by 106 publications

References 18 publications

Typical and atypical antipsychotics differentially affect long-term incidence rates of the metabolic syndrome in first-episode patients with schizophrenia: A retrospective chart review

Typical and atypical antipsychotics differentially affect long-term incidence rates of the metabolic syndrome in first-episode patients with schizophrenia: A retrospective chart review

Olanzapine, weight change and metabolic effects: a naturalistic 12-month follow up

Altered reward anticipation: Potential explanation for weight gain in schizophrenia?

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