Antipsychotic-induced weight gain and therapeutic response: a differential association.
This study investigated the association between antipsychotic-induced weight gain and therapeutic response to haloperidol and three commonly used atypical neuroleptic medications in schizophrenia and schizoaffective disorder. The subjects were 151 patients enrolled in a double-blind experiment with a duration of 14 weeks comparing the therapeutic efficacy of haloperidol (n = 36), clozapine (n = 38), olanzapine (n = 38), and risperidone (n = 39). Absolute and relative (%) gain in body weight and body mass index (BMI) was determined for the entire duration of the double-blind treatment period; therapeutic response was assessed by the total score and the individual subscales of the Positive and Negative Symptom Scale. Compared with the pretreatment baseline, results indicated that for olanzapine and clozapine, therapeutic response was closely related to an absolute and relative gain in weight and to a gain in BMI. No association between weight gain and therapeutic response was found for risperidone and haloperidol. These findings suggest that patients who are likely to have the maximal benefits of olanzapine or clozapine treatment for symptom alleviation are at the highest risk of a clinically significant increase in weight gain.
Czobor
Pál
P
Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York 10962, USA. czobor@NKI.RFMH.ORG
Volavka
Jan
J
Sheitman
Brian
B
Lindenmayer
Jean-Pierre
JP
Citrome
Leslie
L
McEvoy
Joseph
J
Cooper
Thomas B
TB
Chakos
Miranda
M
Lieberman
Jeffrey A
JA
D000328:Adult; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000503:physiopathology; D012559:Schizophrenia / Q000188:drug therapy* / Q000503:physiopathology; D015430:Weight Gain / Q000187:drug effects* / Q000502:physiology
D014150:Antipsychotic Agents