Olanzapine‐associated dose‐dependent alterations for weight and metabolic parameters in a prospective cohort

Schoretsanitis, Georgios; Dubath, Céline; Grosu, Claire; Piras, Marianna; Laaboub, Nermine; Ranjbar, Setareh; Ansermot, Nicolas; Crettol, Séverine; Vandenberghe, Frederik; Gamma, Franziska; Gunten, Armin von; Plessen, Kerstin Jessica; Seifritz, Erich; Conus, Philippe; Eap, Chin B.

doi:10.1111/bcpt.13715

Cited by 11 publications

(6 citation statements)

References 63 publications

(125 reference statements)

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“…We did not observe a dose-dependent effect of olanzapine treatment on body weight gain. This corresponds with previous research showing that lower doses are not necessarily associated with a smaller weight gain ( 35 , 36 ). Previous studies reported that an increase in appetite plays a key role in olanzapine-induced weight gain ( 37 ).…”

Section: Discussionsupporting

confidence: 92%

Longitudinal Gut Microbiota Dysbiosis Underlies Olanzapine-Induced Weight Gain

隆謙

Liu

et al. 2023

Microbiol Spectr

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Section: Discussionsupporting

confidence: 92%

Longitudinal Gut Microbiota Dysbiosis Underlies Olanzapine-Induced Weight Gain

隆謙

Liu

et al. 2023

Microbiol Spectr

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“…This indicates a high validity of our evaluation, including the results on lithium. The deleterious metabolic profile of olanzapine has been well-established in studies of varying designs (Huhn et al 2019 ; Schoretsanitis et al 2022 ), and there have been efforts to mitigate this ADR by a special drug combination, such as combining olanzapine with samidorphan (Meyer et al, 2022 ). A previous analysis of the AMSP dataset also suggested an average weight gain of 1.8 kg/week in patients treated with olanzapine (Schneider et al 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Controversies regarding lithium-associated weight gain: case–control study of real-world drug safety data

Greil,

de Bardeci,

Müller-Oerlinghausen

et al. 2023

Int J Bipolar Disord

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Background The impact of long-term lithium treatment on weight gain has been a controversial topic with conflicting evidence. We aim to assess reporting of weight gain associated with lithium and other mood stabilizers compared to lamotrigine which is considered free of metabolic adverse drug reactions (ADRs). Methods We conducted a case/non-case pharmacovigilance study using data from the AMSP project (German: “Arzneimittelsicherheit in der Psychiatrie”; i.e., Drug Safety in Psychiatry), which collects data on ADRs from patients treated in psychiatric hospitals in Germany, Austria, and Switzerland. We performed a disproportionality analysis of reports of weight gain (> 10% of baseline body weight) calculating reporting odds ratio (ROR). We compared aripiprazole, carbamazepine, lithium, olanzapine, quetiapine, risperidone, and valproate to lamotrigine. Additional analyses related to different mood stabilizers as reference medication were performed. We also assessed sex and age distributions of weight-gain reports. Results We identified a total of 527 cases of severe drug-induced weight gain representing 7.4% of all severe ADRs. The ROR for lithium was 2.1 (95%CI 0.9–5.1, p > 0.05), which did not reach statistical significance. Statistically significant disproportionate reporting of weight gain was reported for olanzapine (ROR: 11.5, 95%CI 4.7–28.3, p < 0.001), quetiapine (ROR: 3.4, 95%CI 1.3–8.4, p < 0.01), and valproate (ROR: 2.4, 95%CI 1.1–5.0, p = 0.03) compared to lamotrigine. Severe weight gain was more prevalent in non-elderly (< 65 years) than in elderly patients, with an ROR of 7.6 (p < 0.01) in those treated with lithium, and an ROR of 14.7 (p < 0.01) in those not treated with lithium. Conclusions Our findings suggest that lithium is associated with more reports of severe weight gain than lamotrigine, although this difference did not reach statistical significance. However, lithium use led to fewer reports of severe weight gain than some alternative drugs for long-term medication (olanzapine, quetiapine, and valproate), which is consistent with recent studies. Monitoring of weight gain and metabolic parameters remains essential with lithium and its alternatives.

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“…This indicates a high validity of our evaluation, including the results on lithium. The deleterious metabolic pro le of olanzapine has been well-established in studies of varying designs (Huhn et al, 2019;Schoretsanitis et al, 2022), and there have been efforts to mitigate this ADR by a special drug combination, such as combining olanzapine with samidorphan (Meyer et al, 2022). A previous analysis of the AMSP dataset also suggested an average weight gain of 1.8 kg/week in patients treated with olanzapine (Schneider et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Controversies regarding Lithium-associated weight gain: Case-control study of real-world drug safety data

Greil,

Bardeci,

Müller-Oerlinghausen

et al. 2023

Preprint

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Background The impact of long-term lithium treatment on weight gain has been a controversial topic with conflicting evidence. We aim to assess reporting of weight gain associated with lithium and other mood stabilizers compared to lamotrigine which is considered free of metabolic adverse drug reactions (ADRs).Methods We conducted a case/non-case pharmacovigilance study using data from the AMSP project (German: "Arzneimittelsicherheit in der Psychiatrie"; i.e., Drug Safety in Psychiatry), which collects data on ADRs from patients treated in psychiatric hospitals in Germany, Austria, and Switzerland. We performed a disproportionality analysis of reports of weight gain (> 10% of baseline body weight) calculating reporting odds ratio (ROR). We compared aripiprazole, carbamazepine, lithium, olanzapine, quetiapine, risperidone, and valproate to lamotrigine. Additional analyses related to different mood stabilizers as reference medication were performed. We also assessed sex and age distributions of weight-gain reports.Results We identified a total of 527 cases of severe drug-induced weight gain representing 7.4% of all severe ADRs. The ROR for lithium was 2.1 (95%CI: 0.9–5.1, p > 0.05), which did not reach statistical significance. Statistically significant disproportionate reporting of weight gain was reported for olanzapine (ROR: 11.5, 95%CI: 4.7–28.3, p < 0.001), quetiapine (ROR: 3.4, 95%CI: 1.3–8.4, p < 0.01), and valproate (ROR: 2.4, 95%CI: 1.1-5.0, p = 0.03) compared to lamotrigine. Severe weight gain was more prevalent in non-elderly (< 65 years) than in elderly patients, with an ROR of 7.6 (p < 0.01) in those treated with lithium, and an ROR of 14.7 (p < 0.01) in those not treated with lithium.Conclusions Our findings suggest that lithium is associated with more reports of severe weight gain than lamotrigine, although this difference did not reach statistical significance. However, lithium use led to fewer reports of severe weight gain than some alternative drugs for long-term medication (olanzapine, quetiapine, and valproate), which is consistent with recent studies. Monitoring of weight gain and metabolic parameters remains essential with lithium and its alternatives.

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Olanzapine‐associated dose‐dependent alterations for weight and metabolic parameters in a prospective cohort

Cited by 11 publications

References 63 publications

Longitudinal Gut Microbiota Dysbiosis Underlies Olanzapine-Induced Weight Gain

Longitudinal Gut Microbiota Dysbiosis Underlies Olanzapine-Induced Weight Gain

Controversies regarding lithium-associated weight gain: case–control study of real-world drug safety data

Controversies regarding Lithium-associated weight gain: Case-control study of real-world drug safety data

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