Weight Gain

Wetterling, Tilman; H, Müssigbrodt

doi:10.1097/00004714-199908000-00006

Cited by 110 publications

(13 citation statements)

References 29 publications

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“…Patients have also complained about restlessness and sleep disturbances [209]. Another important problem with sulpiride is a strong stimulation of prolactin-secretion causing galactorrhea/amenorrhea and a commonly observed increased appetite leading to weight gain [12, 105, 281]. Other adverse reactions occur less frequently (hypotension, rarely long-QT syndrome, dry mouth, sweating, nausea, activation or sedation, insomnia, allergic rash, or pruritus).…”

Section: Pharmacological Treatment Options For Tsmentioning

confidence: 99%

European clinical guidelines for Tourette syndrome and other tic disorders. Part II: pharmacological treatment

Roessner¹,

Plessen²,

Rothenberger³

et al. 2011

Eur Child Adolesc Psychiatry

389

398

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To develop a European guideline on pharmacologic treatment of Tourette syndrome (TS) the available literature was thoroughly screened and extensively discussed by a working group of the European Society for the Study of Tourette syndrome (ESSTS). Although there are many more studies on pharmacotherapy of TS than on behavioral treatment options, only a limited number of studies meets rigorous quality criteria. Therefore, we have devised a two-stage approach. First, we present the highest level of evidence by reporting the findings of existing Cochrane reviews in this field. Subsequently, we provide the first comprehensive overview of all reports on pharmacological treatment options for TS through a MEDLINE, PubMed, and EMBASE search for all studies that document the effect of pharmacological treatment of TS and other tic disorders between 1970 and November 2010. We present a summary of the current consensus on pharmacological treatment options for TS in Europe to guide the clinician in daily practice. This summary is, however, rather a status quo of a clinically helpful but merely low evidence guideline, mainly driven by expert experience and opinion, since rigorous experimental studies are scarce.

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Section: Pharmacological Treatment Options For Tsmentioning

confidence: 99%

European clinical guidelines for Tourette syndrome and other tic disorders. Part II: pharmacological treatment

Roessner¹,

Plessen²,

Rothenberger³

et al. 2011

Eur Child Adolesc Psychiatry

389

398

View full text Add to dashboard Cite

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“…Myocarditis and cardiomyopathy are additional potentially fatal adverse effects that usually occur early in therapy and require discontinuation of the drug [15,[39][40][41]. Other common adverse effects that have not been attributed to higher Cp of clozapine include weight gain [42][43][44], nausea [45], constipation [46], sialorrhea [46,47], hepatotoxicity [48][49][50], eosinophilia [51,52] and akathisia [45,53].…”

Section: Toxicitymentioning

confidence: 99%

CYP-Mediated Clozapine Interactions: How Predictable Are They?

Chetty¹,

Murray

2007

CDM

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Despite the introduction of newer drugs, the atypical antipsychotic clozapine remains the most effective drug in psychotic patients who are resistant to treatment with conventional agents. Optimal therapeutic responses to clozapine have been reported with serum concentrations between 350 microg/L and 1000 microg/L. Clozapine is frequently combined with other drugs to enhance efficacy and reduce adverse reactions but pharmacokinetic interactions can have a significant impact on drug response. The majority of the interactions with clozapine are reported to be mediated by cytochrome P450 (CYP) enzymes. CYP1A2 has a major role in the oxidative metabolism of clozapine, with a minor contribution from CYP3A4, and possibly CYP2D6, CYP2C9 and CYP2C19. Interactions mediated by potent CYP1A2 inhibitors (such as fluvoxamine) or inducers (like cigarette smoke) appear to be consistent, predictable and usually clinically significant. There are many case reports of interactions between clozapine and weak CYP1A2 inhibitors or inducers which are also potent inhibitors or inducers of CYP3A4 or CYP2D6. Researchers often explain these observations on the basis of the CYP1A2 involvement. In addition, there are case reports of clinically significant interactions between clozapine and drugs that are not substrates, inhibitors or inducers of CYP1A2. These interactions are difficult to predict and may not be consistent, as reflected by the conflicting literature reports. Further research to elucidate individual differences in clozapine metabolism, with the potential to detect the dominant roles of CYPs other than CYP1A2, may assist us in predicting these interactions.

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“…The different degree of action of each of these drugs on dopaminergic, serotonergic, H 1 histaminic, and cholinergic receptors may contribute to increased blood sugar [49]. D 2 dopamine receptor blocking, a mechanism common to all antipsychotic drugs, may play a predominant role in causing diabetes.…”

Section: Mechanism Of Diabetogenic Action Of Aap Drugsmentioning

confidence: 99%

Atypical Antipsychotic Drug Use and Diabetes

Ananth

Venkatesh

Burgoyne

et al. 2002

Psychother Psychosom

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Recently, there has been increased concern about the occurrence of diabetes associated with the use of atypical antipsychotic (AAP) drugs. The relationship between diabetes, schizophrenia, and antipsychotic drugs is complex and intriguing, as untreated patients with schizophrenia are known to suffer from diabetes more often than the general population. Thirty individual case reports of clozapine-, 26 cases of olanzapine- and a few others of seroquel- and risperidone-associated diabetes mellitus, hyperglycemia and diabetic ketoacidosis were found by a Medline search. The case reports do not provide the incidence of diabetes in patients treated with AAP drugs, but they suggest that AAP drugs may cause hyperglycemia. Further research is needed to identify the cause of the susceptibility of the schizophrenic population, and to elucidate the mechanisms by which the antipsychotic drugs either cause diabetes or precipitate its onset. Which antipsychotic drugs have a higher and which have a lower potential to induce diabetes is not conclusively answered at present. However, the findings that 50% of the patients completely improve upon drug discontinuation, and that hyperglycemia promptly recurs upon reinstitution of the incriminated drug indicate that this side effect is reversible and is drug related. African Americans are particularly susceptible to AAP drug-induced diabetes. Until the new research data become available, AAP drug treatment of schizophrenic patients aims at prevention, institution of vigilant screening procedures, and management of hyperglycemia.

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Weight Gain

Cited by 110 publications

References 29 publications

European clinical guidelines for Tourette syndrome and other tic disorders. Part II: pharmacological treatment

European clinical guidelines for Tourette syndrome and other tic disorders. Part II: pharmacological treatment

CYP-Mediated Clozapine Interactions: How Predictable Are They?

Atypical Antipsychotic Drug Use and Diabetes

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