Body Weight Changes Associated With Psychopharmacology

Vanina, Yelena; Podolskaya, Anna; Sedky, Karim; Shahab, Hasan; Siddiqui, Abufarah; Munshi, Firoz; Lippmann, Steven

doi:10.1176/appi.ps.53.7.842

Cited by 142 publications

(110 citation statements)

References 48 publications

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“…However, achieving these goals with mentally ill patients poses particular challenges, including difficulty in motivating them to continue in organized programs, limited financial support of all medical services for the chronically and severely mentally ill, and the continuing deleterious physical and metabolic effects of required psychotropic medication. [1][2][3][4][5][6][7] Despite these challenges, our results dispel the belief that chronically ill psychiatric patients are not able, because of mental and physical limitations, to maintain consistent participation in a weight loss program. It is important to note that the present subjects were clinically stable, relatively high functioning (six subjects worked or volunteered, and all but one subject lived alone or with family), and motivated to take part in a weight-loss program.…”

Section: Discussionsupporting

confidence: 51%

“…[1][2][3][4][5][6][7] Risks of weight gain are particularly high with certain modern antipsychotic agents, notably clozapine and olanzapine, [2][3][4][5] with potent interactions with serotonin (especially 5-HT 2C ) and histamine receptors (especially H 1 and H 3 ) implicated in the neurobiology of obesity. [8][9][10][11][12] Weight gain associated with long-term psychotropic drug treatment likely adds to risks of metabolic and general medical disorders that may be more prevalent among persons with chronic major mental illnesses independent of treatment.…”

Section: Introductionmentioning

confidence: 99%

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Weight loss in overweight patients maintained on atypical antipsychotic agents

et al. 2006

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Background: Weight gain and associated medical morbidity offset the reduction of extrapyramidal side effects associated with atypical antipsychotics. Efforts to control weight in antipsychotic-treated patients have yielded limited success. Methods: We studied the impact of an intensive 24-week program of diet, exercise, and counseling in 17 chronically psychotic patients (10 women, seven men) who entered at high average body weight (105.0718.4 kg) and body mass index (BMI) (36.674.6 kg/m 2 ). A total of 12 subjects who completed the initial 24 weeks elected to participate in an additional 24-week, less intensive extension phase. Results: By 24 weeks, weight-loss/patient averaged 6.0 kg (5.7%) and BMI decreased to 34.5 (by 5.7%). Blood pressure decreased from 130/83 to 116/74 (11% improvement), pulse fell slightly, and serum cholesterol and triglyceride concentrations changed nonsignificantly. With less intensive management for another 24 weeks, subjects regained minimal weight (0.43 kg). Conclusions: These findings add to the emerging view that weight gain is a major health problem associated with modern antipsychotic drugs and that labor-intensive weight-control efforts in patients requiring antipsychotic treatment yield clinically promising benefits. Improved treatments without weight-gain risk are needed.

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Section: Discussionsupporting

confidence: 51%

Section: Introductionmentioning

confidence: 99%

Weight loss in overweight patients maintained on atypical antipsychotic agents

et al. 2006

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“…The use of tricyclic antidepressants (TCA) has been associated with metabolic dysregulation, particularly abdominal obesity 10, 23. However, the effects of selective serotonin reuptake inhibitors (SSRIs) on metabolic syndrome components are less clear 24, 25, 26. For instance, SSRI use has been associated with weight gain, loss and no change, as well as both impaired and improved glucose and lipid profiles 23, 26.…”

Section: Introductionmentioning

confidence: 99%

Bidirectional Prospective Associations of Metabolic Syndrome Components With Depression, Anxiety, and Antidepressant Use

et al. 2016

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BackgroundMetabolic syndrome components—waist circumference, high‐density lipoprotein cholesterol (HDL‐C), triglycerides, systolic blood pressure and fasting glucose—are cross‐sectionally associated with depression and anxiety with differing strength. Few studies examine the relationships over time or whether antidepressants have independent effects.MethodsParticipants were from the Netherlands Study of Depression and Anxiety (NESDA; N = 2,776; 18–65 years; 66% female). At baseline, 2‐ and 6‐year follow‐up, participants completed diagnostic interviews, depression and anxiety symptom inventories, antidepressant use assessment, and measurements of the five metabolic syndrome components. Data were analyzed for the consistency of associations between psychopathology indicators and metabolic syndrome components across the three assessment waves, and whether psychopathology or antidepressant use at one assessment predicts metabolic dysregulation at the next and vice versa.ResultsConsistently across waves, psychopathology was associated with generally poorer values of metabolic syndrome components, particularly waist circumference and triglycerides. Stronger associations were observed for psychopathology symptom severity than diagnosis. Antidepressant use was independently associated with higher waist circumference, triglycerides and number of metabolic syndrome abnormalities, and lower HDL‐C. Symptom severity and antidepressant use were associated with subsequently increased number of abnormalities, waist circumference, and glucose after 2 but not 4 years. Conversely, there was little evidence that metabolic syndrome components were associated with subsequent psychopathology outcomes.ConclusionsSymptom severity and antidepressant use were independently associated with metabolic dysregulation consistently over time and also had negative consequences for short‐term metabolic health. This is of concern given the chronicity of depression and anxiety and prevalence of antidepressant treatment.

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“…When there are changes in weight, there are usually associated health hazards, body image and self-esteem are impaired, and this can lead to noncompliance with therapy 19 . It can also lead to obesity, another serious risk factor for cardiovascular diseases and type 2 diabetes.…”

Section: Discussionmentioning

confidence: 99%

Toxicological Profile of Carbamazepine and Levetiracetam on Some Biochemical and Haematological Parameters in Rats

Akunne

Okafor

Igweze³

et al. 2017

PBJ

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The prolonged usage of antiepileptic drugs has necessitated the need to study their toxicological profiles using in experimental animals. The toxicological effects of carbamazepine (CBZ) and levetiracetam (LEV) on some biochemical and haematological parameters were evaluated in rats. Haematological parameters evaluated include packed cell volume (PCV), Haemoglobin (Hb) and white blood cell (WBC), while some biochemical parameters studied were liver enzyme tests such as alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and lipid profiles tests such as total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL). In addition, the body weight and morphological assessment of the vital body organs were determined. Results showed that CBZ and LEV did not significantly affect the haematological parameters. Animals treated with CBZ showed a significant increase in TC and HDL levels at 400 and 1000 mg/kg doses. There was no significant increase in the TC, HDL, LDL and TG in rats treated with LEV. CBZ and LEV treated animals at the doses of 400 and 1000 mg/kg showed a significant increase in body weights from the 6 th day after commencement of treatment. There was also a significant increase in the weights of the liver, kidney and heart of the animals treated with CBZ and LEV. The colour and texture of the organs did not change. However, no appreciable weight increase was observed with the lung.

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Body Weight Changes Associated With Psychopharmacology

Abstract: Careful monitoring and consideration of alternative therapies are essential.

Cited by 142 publications

References 48 publications

Weight loss in overweight patients maintained on atypical antipsychotic agents

Weight loss in overweight patients maintained on atypical antipsychotic agents

Bidirectional Prospective Associations of Metabolic Syndrome Components With Depression, Anxiety, and Antidepressant Use

Toxicological Profile of Carbamazepine and Levetiracetam on Some Biochemical and Haematological Parameters in Rats

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