Effect of atypical antipsychotics on body weight in geriatric psychiatric inpatients

Abstract

Background:Studies suggest that antipsychotic-induced weight gain is not a great concern in the elderly population. This study investigated the weight change in elderly patients with various treatment duration and antipsychotics. Part 1 of the study was to determine whether atypical antipsychotics induced weight change in elderly patients. Part 2 was to determine whether certain atypical antipsychotics induced more weight change in elderly patients.Methods:In Part 1, a retrospective chart review was done on 115 geriatric inpatients. After exclusion, patients were divided into four groups: control (n = 17), new treatment (n = 18), long-term treatment (n = 13), and medication switch groups (n = 8). In Part 2, a retrospective medication review was performed on 169 geriatric inpatients. After exclusion, patients were divided into three groups: aripiprazole (n = 18), olanzapine (n = 49), and risperidone (n = 57). Body weights were obtained at two different time points.Results:No significant difference in weight change was observed among the control (1.5 kg), new treatment (0.8 kg), long-term treatment (−0.3 kg), and medication switch (1.9 kg) groups. No significant difference in weight change was observed between patients with and without dementia (0.8 and 1.1 kg, respectively). The weight change in the aripiprazole group (−2.0 kg; −2.30% from baseline) was significantly different from the weight change in the olanzapine group (0.7 kg; 1.87% from baseline; p < 0.05), but not from the risperidone group (−0.4 kg; −0.45% from baseline). Clinically significant weight gain (>7% increase in body weight) occurred in 14.3% of the olanzapine patients, a percentage significantly higher than the 3.5% in the risperidone group.Conclusion:Although atypical antipsychotics were generally weight neutral in the geriatric population, aripiprazole and olanzapine were associated with significant weight loss and weight gain, respectively.

Pharmacists Becoming Physicians: For Better or Worse?

“…For example, I suggested modifications of pharmacy training to improve their physical examination skills [ 9 ]. Since becoming a physician, I still actively contribute to pharmacology research and have published the findings in medical journals [ 10 , 11 , 12 ].…”

Adverse Events of Risperidone and Clozapine Combination Therapy on Schizophrenic Patients at Magelang Mental Hospital

“…28 Hal ini kemungkinan dipengaruhi oleh perbedaan durasi terapi, total sampel yang digunakan, dan rentang usia subjek dalam penelitian. 29 Dalam penelitian ini, pasien usia ≥60 tahun pasien skizofrenia cenderung mengonsumsi karbohidrat harian yang lebih tinggi jika dibandingkan orang normal terutama pada pasien wanita 407,33±139,89 vs 206,3±7,68 (p=0,000) dan physycal activity level (PAL) lebih rendah (p=0,001). Namun di rumah sakit tempat penelitian dilakukan, hampir semua pasien memiliki aktivitas fisik ≥600 METs-menit/minggu akibat adanya program peningkatan aktivitas fisik, yang pada pasien skizofrenia dapat menurunkan risiko sindroma metabolik.…”

Cytochrome P450 (CYP450) Interactions Involving Atypical Antipsychotics Are Common in Community-Dwelling Older Adults Treated for Behavioral and Psychological Symptoms of Dementia

“…Although aripiprazole may be considered due its potential effectiveness in BPSD as well as its relative milder adverse reaction profile compared to other atypical antipsychotics, it is prudent to evaluate how its addition to a patient's drug regimen may exacerbate the risks associated with the victim drug [5,56,57]. With regards to mirtazapine, it is well known that the properties of the drug allow it to be considered in patients with depressive disorder and challenges with insomnia and/or weight loss.…”