Prevalence of Obesity in Patients Receiving Depot Antipsychotics

Silverstone, Trevor; Smith, Glenyss; Goodall, Edwin

doi:10.1192/bjp.153.2.214

Cited by 106 publications

(45 citation statements)

References 7 publications

(3 reference statements)

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“…The paucity of such side effects as EPS, akathisia, sexual dysfunction, and weight gain, which are leading sources of noncompliance in schizophrenia (Van Putten 1974;Young et al 1986;Pfeiffer et al 1991;Silverstone et al 1988), is encouraging, particularly if this is maintained with long-term ziprasidone treatment. Thus, the over-all safety and tolerability profile evidenced in the study seems favorable.…”

Section: Discussionmentioning

confidence: 99%

Ziprasidone 80 mg/day and 160 mg/day in the Acute Exacerbation of Schizophrenia and Schizoaffective Disorder A 6-Week Placebo-Controlled Trial

Daniel

1999

Neuropsychopharmacology

351

157

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is a novel antipsychotic with high affinity for dopamine D 2 and D 3 , serotonin 5HT 2A , 5HT 2C , and 5HT 1D receptors and high affinity for the 5HT 1A receptor, where it acts as a potent agonist (Seeger et al. 1995) (Table 1).Ziprasidone moderately inhibits 5HT and norepinephrine re-uptake into nerve terminals, has relatively modest affinity for histamine H 1 and adrenergic ␣ 1 receptors, low affinity for dopamine D 1 and ␣ 2 receptors, and negligible affinity for M 1 receptors.In vitro functional dopamine receptor antagonism by ziprasidone has been demonstrated by concentrationdependent blockade of effects induced by a D 2 agonist, quinpirole (inhibition of forskolin-stimulated adenylate cyclase) (Seeger et al. 1995). After systemic administration, ziprasidone produced relatively modest increases in dopamine metabolites as compared with haloperidol (Seeger et al. 1995).

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Section: Discussionmentioning

confidence: 99%

Ziprasidone 80 mg/day and 160 mg/day in the Acute Exacerbation of Schizophrenia and Schizoaffective Disorder A 6-Week Placebo-Controlled Trial

Daniel

1999

Neuropsychopharmacology

351

157

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“…This sideeffect impairs health and promotes premature abandonment of treatment. [1][2][3][4][5] Prolonged administration of diverse AP also increases body weight in female rats. [6][7][8][9][10][11][12][13][14][15][16][17] During SUL treatment (a D 2 -D 3 dopamine receptor antagonist 18 ), the rats display hyperphagia, 6,13 hyperprolactinemia, [11][12][13] and disruption of the vaginal cycle suggesting drug-induced hypogonadism.…”

Section: Introductionmentioning

confidence: 99%

Antipsychotic drug-induced obesity in rats: correlation between leptin, insulin and body weight during sulpiride treatment

Lacruz

Baptista

Mendoza³

et al. 2000

Mol Psychiatry

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Sulpiride (SUL, 20 mg kg −1 day −1 ) induces weight gain, hyperphagia, hyperprolactinemia, hypogonadism, and perhaps increased insulin sensitivity in rats. Leptin seems to signal the brain about the size of body fat stores and nutrient metabolism. We evaluated the basal serum leptin levels in rats after acute (1 h) or prolonged SUL or vehicle administration (10, 20 and 30 days). At days 10 and 30 leptin was also assessed during a glucose overload test. As the maximal weight gain during SUL administration is observed at days 10-15 of treatment, leptin was measured in a comparison group of insulin-treated rats (5 IU day −1 for 10 days). SULtreated rats significantly gained weight. However, leptin levels were not significantly increased at any time-point of treatment. SUL did not affect insulin levels either. By contrast, leptin levels were significantly elevated after insulin administration, along with weight gain and hyperinsulinemia. An opposite correlation was also observed at day 10: leptin and insulin correlated negatively in the SUL group and positively in the insulin group. In addition, leptin and the magnitude of weight gain tended to correlate positively after SUL treatment, but negatively after insulin administration. SUL-treated rats, thus, appear to exhibit an unusual type of weight gain, characterized by normal circulating leptin and insulin levels. Such a particular leptin profile may be related to hyperprolactinemia, hypogonadism or lack of hyperinsulinemia. Molecular Psychiatry (2000) 5, 70-76.

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“…Silverstone et al 28 have assessed 226 patients taking fluphenazine decanoate or flupentixol decanoate and found prevalence of obesity four-fold higher than the general population.…”

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confidence: 99%

Efeitos adversos metabólicos de antipsicóticos e estabilizadores de humor

Teixeira¹,

Rocha

2006

Rev. psiquiatr. Rio Gd. Sul

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INTRODUÇÃO: Um aumento na incidência de obesidade e diabetes melito entre pacientes psiquiátricos foi observado ainda na década de 60, como resultado indesejável do uso de antipsicóticos. Nos anos 80 e 90, a reabilitação da clozapina, a síntese dos demais antipsicóticos atípicos e a disseminação do uso do lítio e do ácido valpróico chamaram novamente a atenção para os efeitos metabólicos desses medicamentos. Este estudo tem por objetivo revisar a literatura médica a respeito dos efeitos adversos metabólicos associados ao uso de antipsicóticos e estabilizadores de humor. MÉTODO: Foi realizada uma extensa pesquisa nas bases de dados MEDLINE e LILACS até outubro de 2005. CONCLUSÃO: Os efeitos adversos metabólicos permanecem como problemas importantes da psicofarmacologia. Ganho de peso clinicamente relevante ocorre com freqüência em pacientes em uso de antipsicóticos e estabilizadores de humor, principalmente naqueles em uso de clozapina, olanzapina, lítio e ácido valpróico. A clozapina e a olanzapina associam-se também a uma maior incidência de diabetes melito e dislipidemias, seja devido ao ganho de peso, seja por ação deletéria direta sobre o metabolismo da glicose. A incidência de obesidade e outros distúrbios metabólicos é menor com a risperidona, se comparada à olanzapina ou à clozapina. Carbamazepina associa-se a menor ganho de peso, se comparada ao lítio ou ao ácido valpróico. Drogas como o haloperidol, a ziprasidona, o aripiprazol e a lamotrigina não estão associadas a ganho importante de peso ou a maior incidência de diabetes melito e são alternativas para pacientes mais propensos a desenvolver tais efeitos adversos.

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Prevalence of Obesity in Patients Receiving Depot Antipsychotics

Cited by 106 publications

References 7 publications

Ziprasidone 80 mg/day and 160 mg/day in the Acute Exacerbation of Schizophrenia and Schizoaffective Disorder A 6-Week Placebo-Controlled Trial

Ziprasidone 80 mg/day and 160 mg/day in the Acute Exacerbation of Schizophrenia and Schizoaffective Disorder A 6-Week Placebo-Controlled Trial

Antipsychotic drug-induced obesity in rats: correlation between leptin, insulin and body weight during sulpiride treatment

Efeitos adversos metabólicos de antipsicóticos e estabilizadores de humor

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