Weight Gain and Serum Leptin Levels in Patients on Lithium Treatment

Abstract

Weight gain is a frequent adverse effect associated with lithium use. Leptin is an adipocyte hormone, regulating food intake and energy balance providing the hypothalamus with information on the amount of body fat. Therefore, we planned to evaluate whether lithium administration was associated with weight gain, and leptin levels. The study consisted of 15 consecutive inpatients with bipolar I disorder according to DSM-III-R. The fasting serum leptin levels were measured. The patients were evaluted at baseline and at the eighth week according to the body mass index, weight, Young Mania Rating (YMRS) and Hamilton Depression Rating (HAM-D) scales, and serum leptin levels. With respect to the leptin levels, a significant difference was observed after lithium treatment. There was a significant positive correlation between the changes in leptin levels and the duration of illness. The change in total YMRS scores correlated with change in leptin levels and that in weight. In conclusion, our result suggest that leptin may be associated with lithium-induced weight gain.

Biological aging alters circadian mechanisms in murine adipose tissue depots

“…The serum levels of glucocorticoids and melatonin, factors with potent adipogenic properties, exhibit circadian oscillations (Hirota and Fukada 2004;Lowrey and Takahashi 2004). Eating during periods of darkness (Holmback et al 2002(Holmback et al , 2003Spiegel et al 2004) and antipsychotic drugs influencing circadian rhythms such as lithium chloride and valproic acid (Baptista et al 1995;Elmslie et al 2001;Atmaca et al 2002;Chengappa et al 2002;Fagiolini et al 2002Fagiolini et al , 2003Iwahana et al 2004) have been associated with an increased incidence of obesity. The serum levels of multiple adipose-derived proteins, including adiponectin, interleukin-6, leptin, lipoprotein lipase, PAI-1, and tumor necrosis factor-α, display a diurnal profile characterized by a distinct amplitude, zenith (peak), and nadir (trough) (Kotlar and Borensztajn 1977;Goubern and Portet 1981;Saad et al 1998;Ahmad et al 2001;Arasaradnam et al 2002;Mastronardi et al 2002;Gavrila et al 2003;Calvani et al 2004;Ruge et al 2004;Yildiz et al 2004).…”

Comorbidity

“…Lithium (Vendsborg et al 1976 ;Sachs et al 2006 ) and valproate (Dinesen et al 1984 ;Pylvanen et al 2002 ;Swann 2001 ) can cause weight gain. It has been reported that patients on lithium gain weight in contrast to patients under lamotrigine Muller-Oerlinghausen et al 1979 ;Atmaca et al 2002 ;Vendsborg et al 1976 ) and weight gain during lithium treatment has shown to lead to poor adherence (Gitlin et al 1989 ). Treatment with antipsychotics and especially with those belonging to the second generation has also been related to weight gain (Henderson et al 2000 ;Simpson 2005 ;Volavka et al 2002 ;Zipursky et al 2005 ;Nasrallah 2003 ).…”

Endocrine disturbances related to the use of lithium

“…One possibility may be related to the stimulation of a greater intake of high-calorie beverages, especially in patients with polydipsia (44,57). Some studies also show changes in leptin levels, which ultimately can be involved in weight gain (58).…”