Weight gain associated with olanzapine and risperidone in adolescent patients: a comparative prospective study.
OBJECTIVE
To evaluate weight gain associated with olanzapine, risperidone, and haloperidol treatment and its clinical risk factors in adolescent patients.


METHODS
The study was conducted at three adolescent psychiatric departments in two mental health centers in the Tel Aviv area. All patients were Jewish Israelis. Weight and body mass index (BMI) of hospitalized adolescents treated with olanzapine (n = 21), risperidone (n = 21), or haloperidol (n = 8) were prospectively monitored on a weekly basis for the first 12 weeks of treatment. Various clinical risk factors were tested for association with weight gain.


RESULTS
The olanzapine and risperidone groups experienced significant weight gain between baseline and endpoint (p < .01), whereas the average weight of the haloperidol group did not change. Average weight gain was significantly higher for the olanzapine group (7.2 +/- 6.3 kg, 11.1% +/- 7.8%) than for the risperidone (3.9 +/- 4.8 kg, 6.6% +/- 8.6%) and haloperidol (1.1 +/- 3.3 kg, 1.5% +/- 6.0%) groups. Extreme weight gain (>7%) was recorded in 19 patients (90.5%), 9 patients (42.9%), and 1 (12.5%) patient, respectively Gender (males), low concern about gaining weight (females), low baseline BMI, and paternal BMI were positively correlated with weight gain, whereas previous neuroleptic history, neuroleptic dosage, response to treatment, and illness duration were not.


CONCLUSIONS
Olanzapine and risperidone are associated with extreme weight gain in adolescents, much higher than that reported in adults. This side effect should be taken into consideration before prescribing these medications, especially in patients at high risk.
Ratzoni
Gidi
G
Adolescent Inpatient Unit, Shalvata Mental Health Center, Hod Hasharon, Israel.
Gothelf
Doron
D
Brand-Gothelf
Ayelet
A
Reidman
Judith
J
Kikinzon
Leonid
L
Gal
Gilad
G
Phillip
Moshe
M
Apter
Alan
A
Weizman
Ronit
R
D000293:Adolescent; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines; D005260:Female; D006220:Haloperidol / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy*; D000077152:Olanzapine; D010890:Pirenzepine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D011446:Prospective Studies; D018967:Risperidone / Q000627:therapeutic use*; D015430:Weight Gain
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D010890:Pirenzepine; D006220:Haloperidol; D018967:Risperidone; D000077152:Olanzapine