Antipsychotic-induced body weight gain: predictors and a systematic categorization of the long-term weight course.
OBJECTIVE
To explore the impact of premorbid and baseline body mass indices (BMIs) as well as BMI of patient's parents and associated variables on the prediction of antipsychotic-induced body weight gain.


METHODS
Retrospective/cross-sectional data of 65 patients receiving clozapine, olanzapine and/or risperidone were assessed according to a systematic categorization of the long-term (7.3+/-9.2 years) weight course and evaluated using descriptive, explorative correlation and regression analyses.


RESULTS
Increased values of parents' BMI (p=0.041) and patients' BMI at premorbid stage (p=0.039) and prior to first antipsychotic treatment (p=0.032) as well as female gender (p=0.012), younger age (p=0.005) and non-smoking (p=0.047) have the most predictive value on body weight gain under antipsychotic treatment including pre-treatment with typical antipsychotics. Weight gain under atypical antipsychotics (pre-treatment excluded) is predicted by an increased premorbid BMI (p=0.019). Conversely, a low BMI prior to first antipsychotic treatment predicts a higher acceleration of BMI change (p=0.008) in vulnerable individuals, but not total BMI change itself. Furthermore, a diagnosis of a schizophrenia spectrum disorder showed a trend towards the prediction of an increased atypical DeltaBMI (p=0.067), possibly due to a longer treatment duration with atypical antipsychotics (p<0.001).


CONCLUSIONS
The study indicates increased parents' BMI and patients' premorbid BMI, female gender, younger age and - as a trend - the diagnosis of a schizophrenia spectrum disorder to be predictors for antipsychotic-induced body weight gain involving atypical antipsychotics. Data contribute to the assumption of a strong impact of predispositional factors on weight gain, besides treatment-related factors.
Gebhardt
Stefan
S
Department of Psychiatry and Psychotherapy, University of Marburg, Rudolf-Bultmann-Str. 8, D-35033 Marburg, Germany. Stefan.Gebhardt@med.uni-marburg.de
Haberhausen
Michael
M
Heinzel-Gutenbrunner
Monika
M
Gebhardt
Nadine
N
Remschmidt
Helmut
H
Krieg
Jürgen-Christian
JC
Hebebrand
Johannes
J
Theisen
Frank M
FM
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects; D003024:Clozapine / Q000009:adverse effects / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D010290:Parents; D012189:Retrospective Studies; D012307:Risk Factors; D018967:Risperidone / Q000009:adverse effects / Q000627:therapeutic use; D012737:Sex Factors; D012907:Smoking; D013997:Time Factors; D015430:Weight Gain / Q000187:drug effects*; D055815:Young Adult
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D003024:Clozapine; D018967:Risperidone; D000077152:Olanzapine