Weight and blood pressure changes after switching second-generation antipsychotics in a population of veterans with schizophrenia-related disorders.
OBJECTIVE
To describe (1) the association between systolic blood pressure (SBP) and diastolic blood pressure (DBP) changes and weight change and (2) weight, SBP, and DBP changes attributable to the medication following a switch from one second-generation antipsychotic (SGA) to another.


METHODS
Retrospective, naturalistic, nonequivalent control group study.


METHODS
United States between April 1, 2002, and September 30, 2002.


METHODS
1,425 U.S. Veterans Healthcare System enrollees with diagnoses of schizophrenia or schizoaffective disorders.


METHODS
Analysis of data from the Veterans Integrated System Technology Architecture.


METHODS
Veterans' weight, SBP, and DBP.


RESULTS
Weight change and change in SBP (r = 0.19) and DBP (r = 0.15) were significant (P < 0.001), even after adjusting for obesity status (body mass index <30 or > or = 30 kg/m2). Veterans who were switched from olanzapine to another SGA lost weight (P < 0.001), whereas those switched from another SGA to olanzapine gained weight (P < 0.05). Weight change remained significant after controlling for preswitch obesity status (P < 0.001). Blood pressure was not associated with switch type after adjusting for preswitch obesity status.


CONCLUSIONS
Monitoring and aggressively treating weight change is an evidence-based and relatively inexpensive strategy that primary care practitioners and psychiatrists can use in working in tandem toward reducing the already greater cardiovascular risk of patients with schizophrenia.
Ried
L Douglas
LD
Rehabilitation Outcomes Research Center, Malcom Randall Veterans Affairs Medical Center, Gainesville, FL, USA. ried@cop.ufl.edu
McConkey
Joel R
JR
Bengtson
Michael A
MA
Garman
Patrick M
PM
Hsu
Chienning
C
Rahnavard
Farzad
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001569:Benzodiazepines / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects*; D001835:Body Weight / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D012559:Schizophrenia / Q000188:drug therapy* / Q000503:physiopathology; D014728:Veterans
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000077152:Olanzapine