Factors influencing acute weight change in patients with schizophrenia treated with olanzapine, haloperidol, or risperidone.
OBJECTIVE
Clinical factors predicting weight change in patients with schizophrenia and related disorders during acute treatment with the antipsychotic drugs olanzapine, risperidone, and haloperidol were sought through retrospective analyses.


METHODS
Six-week body-weight data from 2 trials, study 1 comparing olanzapine and haloperidol (N = 1,369) and study 2 olanzapine and risperidone (N = 268), were analyzed. Effects of 8 clinically relevant covariates--therapy, clinical outcome (Brief Psychiatric Rating Scale), baseline body mass index (BBMI), increased appetite, age, gender, race, and dose--on weight were compared.


RESULTS
In study 1, olanzapine (vs. haloperidol) therapy, better clinical outcome, lower BBMI, and nonwhite race significantly affected weight gain. Effects of increased appetite and male gender on weight gain were significant for olanzapine but not for haloperidol. In study 2, better clinical outcome, lower BBMI, and younger age significantly affected weight gain. Increased appetite was more frequent during olanzapine treatment than during haloperidol, but not significantly different from risperidone. Significant differences in effect on weight change were found between olanzapine and haloperidol but not between olanzapine and risperidone. No evidence was found that lower antipsychotic drug doses were associated with lower weight gain.


CONCLUSIONS
This report identifies predictive factors of acute weight change in patients with schizophrenia. Similar factors across antipsychotic drugs in predicting greater weight gain included better clinical outcome, low BBMI, and nonwhite race. Factors differing between conventional (haloperidol) and atypical (olanzapine) agents included increased appetite and gender. Choice of atypical antipsychotic drug (olanzapine vs. risperidone) was of minor importance with regard to influence on acute weight gain.
Basson
B R
BR
Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, Ind 46285, USA.
Kinon
B J
BJ
Taylor
C C
CC
Szymanski
K A
KA
Gilmore
J A
JA
Tollefson
G D
GD
D000328:Adult; D000367:Age Factors; D014150:Antipsychotic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001066:Appetite / Q000187:drug effects; D001569:Benzodiazepines; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects*; D010054:Brief Psychiatric Rating Scale / Q000706:statistics & numerical data; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006220:Haloperidol / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D000077152:Olanzapine; D010890:Pirenzepine / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use*; D044469:Racial Groups; D012189:Retrospective Studies; D012307:Risk Factors; D018967:Risperidone / Q000494:pharmacology / Q000627:therapeutic use*; D012559:Schizophrenia / Q000188:drug therapy*; D012737:Sex Factors; D016896:Treatment Outcome; D015430:Weight Gain / Q000187:drug effects
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D010890:Pirenzepine; D006220:Haloperidol; D018967:Risperidone; D000077152:Olanzapine