Effect of antipsychotics on peptides involved in energy balance in drug-naive psychotic patients after 1 year of treatment.
Weight gain has become one of the most common and concerning side effects of antipsychotic treatment. The mechanisms whereby antipsychotics induce weight gain are not known. It has been suggested that peptides related to food intake and energy balance could play a role in weight gain secondary to antipsychotic therapy. To better understand the pathophysiology of antipsychotic-induced weight gain, we studied the effects of 3 antipsychotic drugs (haloperidol, olanzapine, and risperidone) on peptides involved in energy balance (insulin, ghrelin, leptin, adiponectin, visfatin, and resistin) in a population of drug-naive patients with first episode of psychosis.A significant increase in weight (10.16 kg [SD, 8.30 kg]; P < 0.001), body mass index (3.56 kg/m [SD, 2.89 kg/m]; P < 0.001), and fasting insulin (3.93 muU/mL [SD, 3.93 muU/mL]; P = 0.028), leptin (6.76 ng/mL [SD, 7.21 ng/mL]; P < 0.001), and ghrelin (15.47 fmol/mL [SD, 47.90 fmol/mL]; P = 0.009) plasma levels were observed. The increments in insulin and leptin concentrations were highly correlated with the increment in weight and body mass index and seem to be a consequence of the higher fat stores. The unexpected increase in ghrelin levels might be related with the causal mechanism of weight gain induced by antipsychotics. Finally, the 3 antipsychotics had similar effects in all parameters evaluated.
Perez-Iglesias
Rocio
R
Department of Psychiatry, Marqués de Valdecilla University Hospital, University of Cantabria, Cantabria, Spain.
Vazquez-Barquero
Jose Luis
JL
Amado
Jose Antonio
JA
Berja
Ana
A
Garcia-Unzueta
Maria Teresa
MT
Pelayo-Terán
Jose María
JM
Carrasco-Marín
Eugenio
E
Mata
Ignacio
I
Crespo-Facorro
Benedicto
B
D052242:Adiponectin / Q000097:blood; D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use / Q000633:toxicity*; D001569:Benzodiazepines / Q000627:therapeutic use / Q000633:toxicity; D001823:Body Composition / Q000187:drug effects; D015992:Body Mass Index; D004305:Dose-Response Relationship, Drug; D004734:Energy Metabolism / Q000187:drug effects*; D005260:Female; D054439:Ghrelin / Q000097:blood*; D006220:Haloperidol / Q000627:therapeutic use / Q000633:toxicity; D006801:Humans; D007328:Insulin / Q000097:blood*; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D054409:Nicotinamide Phosphoribosyltransferase / Q000097:blood; D000077152:Olanzapine; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000097:blood / Q000188:drug therapy*; D052243:Resistin / Q000097:blood; D018967:Risperidone / Q000627:therapeutic use / Q000633:toxicity; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy*; D015430:Weight Gain / Q000187:drug effects*
D052242:Adiponectin; D014150:Antipsychotic Agents; D054439:Ghrelin; D007328:Insulin; D020738:Leptin; D052243:Resistin; D001569:Benzodiazepines; D054409:Nicotinamide Phosphoribosyltransferase; D006220:Haloperidol; D018967:Risperidone; D000077152:Olanzapine