Weight loss in overweight patients maintained on atypical antipsychotic agents.
BACKGROUND
Weight gain and associated medical morbidity offset the reduction of extrapyramidal side effects associated with atypical antipsychotics. Efforts to control weight in antipsychotic-treated patients have yielded limited success.


METHODS
We studied the impact of an intensive 24-week program of diet, exercise, and counseling in 17 chronically psychotic patients (10 women, seven men) who entered at high average body weight (105.0+/-18.4 kg) and body mass index (BMI) (36.6+/-4.6 kg/m(2)). A total of 12 subjects who completed the initial 24 weeks elected to participate in an additional 24-week, less intensive extension phase.


RESULTS
By 24 weeks, weight-loss/patient averaged 6.0 kg (5.7%) and BMI decreased to 34.5 (by 5.7%). Blood pressure decreased from 130/83 to 116/74 (11% improvement), pulse fell slightly, and serum cholesterol and triglyceride concentrations changed nonsignificantly. With less intensive management for another 24 weeks, subjects regained minimal weight (0.43 kg).


CONCLUSIONS
These findings add to the emerging view that weight gain is a major health problem associated with modern antipsychotic drugs and that labor-intensive weight-control efforts in patients requiring antipsychotic treatment yield clinically promising benefits. Improved treatments without weight-gain risk are needed.
Centorrino
F
F
Consolidated Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA, USA. centorf@mclean.org
Wurtman
J J
JJ
Duca
K A
KA
Fellman
V H
VH
Fogarty
K V
KV
Berry
J M
JM
Guay
D M
DM
Romeling
M
M
Kidwell
J
J
Cincotta
S L
SL
Baldessarini
R J
RJ
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001794:Blood Pressure; D015992:Body Mass Index; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003376:Counseling; D004038:Diet, Reducing; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000139:chemically induced* / Q000503:physiopathology / Q000628:therapy*; D050177:Overweight / Q000187:drug effects*; D015397:Program Evaluation; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000503:physiopathology; D012559:Schizophrenia / Q000188:drug therapy / Q000503:physiopathology; D016896:Treatment Outcome; D015431:Weight Loss
D014150:Antipsychotic Agents