title: The association between weight change and symptom reduction in the CATIE schizophrenia trial.
abstract: BACKGROUND
  Weight gain and changes in metabolic indicators associated with some antipsychotics may be related to symptom improvement and thus an unavoidable correlate of clinical benefit.
  
  
  METHODS
  Data from the CATIE schizophrenia trial comparing the effectiveness of perphenazine, olanzapine, risperidone, quetiapine and ziprasidone in a randomized, double-blind, trial over 18 months were used to evaluate the relationship between percent change in body mass index (BMI) and change in total serum cholesterol and triglycerides with the Positive and Negative Syndrome Scale (PANSS) score. Analysis of covariance for observations at 3 months and a mixed effects model for all observations up to 18 months adjusted for potentially confounding variables were used to examine these associations.
  
  
  RESULTS
  In both models, there was a significant association (p = 0.001) between change in PANSS total score and percent change in BMI, equating to a 0.28 and 0.21 point decrease in PANSS total score (range 30-210) per 1% increase in BMI respectively. Change in BMI accounted for 3% or less of variance for change in PANSS scores. There was no evidence that the association of symptoms and weight gain differed across medications in spite of substantial differences in weight gain and other metabolic measures. Neither total serum cholesterol nor triglyceride levels displayed a significant association with change in PANSS.
  
  
  CONCLUSIONS
  The magnitude of the relationship between change in BMI and PANSS was too small to be clinically important, indicating that switching medications to one with less metabolic risk is unlikely to result in meaningful loss of clinical benefit.
authors.affiliation: Department of Psychiatry, Yale School of Medicine, 300 George Street, Ste. 901, New Haven, CT 06511, USA. Eric.Hermes@yale.edu
authors.forename: Eric
authors.initials: E
authors.lastname: Hermes
authors.forename: Henry
authors.initials: H
authors.lastname: Nasrallah
authors.forename: Vicki
authors.initials: V
authors.lastname: Davis
authors.forename: Jonathan
authors.initials: J
authors.lastname: Meyer
authors.forename: Joseph
authors.initials: J
authors.lastname: McEvoy
authors.forename: Donald
authors.initials: D
authors.lastname: Goff
authors.forename: Sonia
authors.initials: S
authors.lastname: Davis
authors.forename: T Scott
authors.initials: TS
authors.lastname: Stroup
authors.forename: Marvin
authors.initials: M
authors.lastname: Swartz
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Lieberman
authors.forename: Robert
authors.initials: R
authors.lastname: Rosenheck
mesh_terms: D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000627:therapeutic use; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects / Q000502:physiology*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012559:Schizophrenia / Q000188:drug therapy / Q000503:physiopathology*; D013997:Time Factors; D014280:Triglycerides / Q000097:blood / Q000134:cerebrospinal fluid
chemical_list: D014150:Antipsychotic Agents; D014280:Triglycerides