Effects of Olanzapine and Risperidone on Metabolic Factors in Children and Adolescents: A Retrospective Evaluation

Abstract

Inpatient treatment with both olanzapine and risperidone was correlated with a significant increase in BMI. Olanzapine also resulted in increased risk factors for diabetes and metabolic syndrome.

Cardiometabolic risk and the MTHFR C677T variant in children treated with second-generation antipsychotics

“…A study in children treated with risperidone and followed for 8 weeks found significant increases in body weight, BMI Z -scores and waist circumference, but no differences in plasma lipids or glucose. 19 Another study showed that children treated with olanzapine and risperidone and followed for 4 weeks had significant increases in BMI, but only those treated with olanzapine had elevations in blood pressure and diagnosis of MetS from baseline 20 suggesting the type of SGA-treatment may influence the development of MetS characteristics. However, in our current study only 3.8% of the children were treated with olanzapine, with the majority treated with either risperidone (43.8%) or quetiapine (46.7%), similar to our prior study.…”

Zonisamide for Attenuation of Weight Gain in a Morbidly-Obese Adolescent on an Antipsychotic

“…Khan reviewed the effects of olanzapine and risperidone on patients (mean age of 13) over a 27-day duration. They showed that the study group had a significant increase in Body Mass Index (BMI) for both medications with mean increases in weight being 9.1 lbs and 7.4 lbs, respectively [11]. Though the amount of weight gained varies with each SGA and may be person-specific, it is becoming clearer that weight gain in children and adolescents on SGAs is the trend and not the exception.…”

Relationship between Antipsychotics and Weight in Patients with Prader-Willi Syndrome

“…Of the 20 PWS cases who were AP na€ ıve at admission and subsequently started an AP during their inpatient stay, 11 were matched exactly to 11 PWS controls according to age, sex, raceethnicity, genetic type, and IQ score. Age (yrs), sex, race-ethnicity, and genetic type were matched exactly, and IQ score was matched according to the following categories: no mental retardation (> 70), mild retardation (50-69), moderate retardation (35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49), severe retardation (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34), and profound retardation (< 20). These cases and controls could be matched on genetic type and IQ score in addition to age, sex, and race-ethnicity due to the large difference in sample size between the cases (n=11) and pool of controls (n=338).…”

“…There is a well‐documented association between AP use and the development of rapid and extensive weight gain in the general population . Several mechanisms have been postulated for the associated weight gain, including blockade of the serotonin 5‐HT 2C and histamine H 1 receptors, antagonism of dopamine and norepinephrine at the hypothalamus (affecting satiety), and changes in leptin, prolactin, cytokines, reproductive hormones, and cortisol levels . Although previous research has shown that some of the newer, second‐generation APs (SGAs) result in more weight gain than certain older, first‐generation APs (FGAs), recent evidence suggests that the risk for weight gain and metabolic complications is not class specific and varies within each class .…”

“…29,30 Several mechanisms have been postulated for the associated weight gain, including blockade of the serotonin 5-HT 2C and histamine H 1 receptors, antagonism of dopamine and norepinephrine at the hypothalamus (affecting satiety), and changes in leptin, prolactin, cytokines, reproductive hormones, and cortisol levels. [31][32][33][34][35][36][37][38] Although previous research has shown that some of the newer, second-generation APs (SGAs) result in more weight gain than certain older, first-generation APs (FGAs), 39,40 recent evidence suggests that the risk for weight gain and metabolic complications is not class specific and varies within each class. 41 For example, mid-to high-potency FGAs likely have a similar risk for weight gain and metabolic complications as low-risk SGAs.…”