Weight Management Program for Treatment-Emergent Weight Gain in Olanzapine-Treated Patients With Schizophrenia or Schizoaffective Disorder

Abstract

Background: The main objective was to assess the efficacy of a weight management program designed for outpatients taking olanzapine for schizophrenia or schizoaffective disorder and to compare these patients with a randomized control group. The effects of the weight management program were also assessed with regard to safety and quality of life. Method: Forty-eight patients were enrolled in a 12-week, randomized, multicenter weight management study. Thirty-three patients were randomly allocated to an intervention group in which they received olanzapine within a weight management program. Fifteen patients were allocated to a control group in which they were given olanzapine treatment as usual outpatients. Weight, body mass index (BMI), and measurements of safety and quality of life were evaluated. The study was conducted from January 7, 2003, to September 16, 2003. Results: Thirty-six patients (75%) completed this study. We found significant differences in weight (-3.94 ± 3.63 kg vs.-1.48 ± 1.88 kg, p = .006) and BMI (-1.50 ± 1.34 vs.-0.59 ± 0.73, p = .007) change from baseline to endpoint between the intervention and control groups, respectively. Significant differences in weight reduction were initially observed at week 8 (p = .040). No significant differences were found with regard to the safety outcomes. When the ratio of low-density lipoproteins to high-density lipoproteins was calculated, change from baseline was greater in the intervention group than the control group (-0.19 vs.-0.04), but the difference was not statistically significant (p = .556). After the completion of the weight management program, there was a trend toward statistical difference in the physical health score changes between the weight management and control groups (1.12 in the intervention group vs.-0.93 in the control group, p = .067). Conclusion: The weight management program was effective in terms of weight reduction in patients with schizophrenia or schizoaffective disorder taking olanzapine and was also found to be safe in terms of psychiatric symptoms, vital signs, and laboratory data. In addition, such a weight management program might improve quality of life in patients with schizophrenia or schizoaffective disorder with respect to their physical well-being.

The 2009 Schizophrenia PORT Psychosocial Treatment Recommendations and Summary Statements

“…201,203,205,206 In terms of duration, interventions varied in length from 3 203 to 6 months. 205 Regarding setting, 1 of the trials was completed in an inpatient setting, 205 5 were completed across a range of outpatient settings, [201][202][203][204]206 and 1 trial was completed in both inpatient and outpatient settings.…”

“…205 Regarding setting, 1 of the trials was completed in an inpatient setting, 205 5 were completed across a range of outpatient settings, [201][202][203][204]206 and 1 trial was completed in both inpatient and outpatient settings. 200 Six of the 7 studies specified that all study participants were overweight and were also taking first-or secondgeneration antipsychotic medications; 2 of these studies focused on individuals taking olanzapine who had recently experienced olanzapine-related weight gain, [200][201][202][203] 1 focused on individuals with a BMI greater than 27 who were also taking clozapine, 205 2 included overweight individuals (ie, individuals with BMI >25) who were taking a first-or second-generation antipsychotics (ie, clozapine, olanzapine, risperidone, haloperidol, perphenazine, thiothixene, fluphenazine, quetiapine, and ziprasidone), [202][203][204] and 1 included individuals who had gained 10% of their body weight within 1 year following the initiation of antipsychotic medication, who were also taking clozapine, olanzapine, risperidone, and sulpiride. 206 The investigation by Brown and Chan 201 was the only investigation that did not specify weight or medication inclusion criteria.…”

The effectiveness of a non-pharmacological intervention for weight gain management in severe mental disorders: results from a national multicentric study

“…14,15,17,18 Compliance with obesity treatment is hard to achieve even in the general population, considering that most obese people, if left untreated for 3 to 5 years, would probably gain 0.5-1kg per year. 19 The problem is even worse in patients with chronic and severe mental disorders due to unhealthy lifestyle, use of antipsychotics and negative symptoms.…”

Alteraciones metabólicas asociadas al uso de terapia antipsicótica

“…Existe en el equipo de salud una visión predeterminada negativa en relación a la capacidad que estos pacientes tienen de adoptar estilos de alimentación saludable y actividad física regular, sin embar-go hay publicaciones que muestran que sujetos esquizofrénicos son capaces de modificar estos hábitos 52 , logrando resultados positivos en baja de peso y corrección de parámetros metabólicos, como insulinemia, glicemia e hipertrigliceridemia [53][54][55] .…”