title: Improved body weight and metabolic outcomes in overweight or obese psychiatric patients switched to amisulpride from other atypical antipsychotics.
abstract: Switching to a different second-generation antipsychotic (SGA) with a lower risk of weight gain is recommended for overweight or obese psychiatric patients undergoing SGA treatment. However, there have been no complete reports regarding the long-term metabolic effects of switching to amisulpride. In this open-label 1-year study, we investigated the effects on body weight and other metabolic profiles when psychiatric patients treated with another SGA were switched to amisulpride treatment. Forty-six schizophrenia or schizoaffective inpatients with a body mass index greater than 27 kg/m were enrolled in the switch group. These patients were cross-titrated to amisulpride treatment and followed up for 1 year prospectively. Another 46 inpatients matched with the baseline body mass index of those in the switch group were enrolled as the control group retrospectively. The results showed that the switch group had greater weight loss than the control group (7.80 +/- 6.67 vs 2.60 +/- 6.23 kg, respectively; repeated-measure analysis of variance, P < 0.0005). During the treatment course, the amisulpride-treated patients showed significantly decreased fasting triglyceride, total cholesterol, glucose, and insulin resistance levels; decreased diastolic blood pressure and pulse rate; and a significant increase in high-density lipoprotein cholesterol levels after switching to amisulpride (all with a P < 0.05). The prevalence of metabolic syndrome in amisulpride-treated patients also decreased significantly from 65.2% to 30.4% (McNemar test, P < 0.0005). These findings suggest that switching to amisulpride could be an effective treatment of overweight or obese psychiatric patients treated previously with other SGAs.
authors.affiliation: Department of Psychiatry, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Chao-Cheng
authors.initials: CC
authors.lastname: Lin
authors.forename: Ya-Mei
authors.initials: YM
authors.lastname: Bai
authors.forename: Ying-Chieh
authors.initials: YC
authors.lastname: Wang
authors.forename: Tzu-Ting
authors.initials: TT
authors.lastname: Chen
authors.forename: I-Ching
authors.initials: IC
authors.lastname: Lai
authors.forename: Jen-Yeu
authors.initials: JY
authors.lastname: Chen
authors.forename: Shiow-Yi
authors.initials: SY
authors.lastname: Chen
authors.forename: Susan S F
authors.initials: SS
authors.lastname: Gau
authors.forename: Ying-Jay
authors.initials: YJ
authors.lastname: Liou
mesh_terms: D000328:Adult; D000077582:Amisulpride; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001835:Body Weight / Q000187:drug effects / Q000502:physiology*; D004734:Energy Metabolism / Q000187:drug effects / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000378:metabolism*; D008875:Middle Aged; D009765:Obesity / Q000188:drug therapy / Q000378:metabolism; D050177:Overweight / Q000188:drug therapy / Q000378:metabolism*; D011446:Prospective Studies; D013469:Sulpiride / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D013469:Sulpiride; D000077582:Amisulpride