Weight gain in newly diagnosed first-episode psychosis patients and healthy comparisons: one-year analysis.
BACKGROUND
Various antipsychotics are associated with body weight gain. However, most study samples include high proportions of patients with chronic schizophrenia. We examined neuroleptic-induced weight gain in drug-naïve first-episode psychotic patients to limit confounding variables such as multiple past medication trials, history of partial adherence; or poor diet and a sedentary lifestyle, associated with chronic mental illness.


METHODS
Newly diagnosed first-episode psychosis patients treated with antipsychotic medication, a small group of patients not receiving antipsychotics, and healthy comparisons were followed for one year. Body weight differences and proportions of subjects with more than 7% weight gain were calculated. The effects of concomitant psychotropic medication on weight gain were explored.


RESULTS
Ninety-eight first-episode psychotics patient and 30 healthy controls were examined. Patients receiving neuroleptics gained significantly more weight than healthy controls (p=0.002). Olanzapine (91% gained >7%) increased body weight by 37.3+/-27.7 lb, followed by risperidone (51%; +16.6+/-22) and haloperidol (47%; +9+/-12), and perphenazine (10%; +3.4+/-6). Younger patients (r=-0.24, p=0.02) and patients with more negative symptoms at baseline (SANS global; r=0.22, p=0.04) gained more weight. A greater number of co-medications per patient, and co-prescription of antidepressants significantly and independently increased antipsychotic-associated weight gain.


CONCLUSIONS
The results confirm substantial and clinically significant weight gain introduced by antipsychotic treatment in drug-naïve first-episode psychotic patients, and identify several treatment-associated risk factors for weight gain. The magnitude of weight gain induced highlights potential health risks and points to the need for preventive measures such as behavioral weight control programs along with the initiation of pharmacotherapy.
Strassnig
Martin
M
Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, 3811 O'Hara Street, Pittsburgh, PA 15213, United States.
Miewald
Jean
J
Keshavan
Matcheri
M
Ganguli
Rohan
R
D000328:Adult; D000341:Affective Disorders, Psychotic / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D015992:Body Mass Index; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006220:Haloperidol / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D000077152:Olanzapine; D010546:Perphenazine / Q000009:adverse effects / Q000627:therapeutic use; D011569:Psychiatric Status Rating Scales; D012016:Reference Values; D018967:Risperidone / Q000009:adverse effects / Q000627:therapeutic use; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D015430:Weight Gain / Q000187:drug effects*
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D010546:Perphenazine; D006220:Haloperidol; D018967:Risperidone; D000077152:Olanzapine