title: Placebo-controlled trial of atomoxetine for weight reduction in people with schizophrenia treated with clozapine or olanzapine.
abstract: BACKGROUND
  In recent years, several pharmacological and psychosocial interventions have examined ways to prevent or treat weight gain in people receiving second-generation antipsychotics. While there has been some success, in general, results have not been compelling. Atomoxetine is a selective norepinepherine reuptake inhibitor found to be associated with appetite suppression. Therefore, we examined whether atomoxetine may be of benefit for those who have gained weight on either clozapine or olanzapine.
  
  
  METHODS
  The study was a double-blind, placebo-controlled trial. All participants received the same psychosocial platform: a structured support and exercise group. People with schizophrenia or schizoaffective disorder, on olanzapine or clozapine, who had gained at least 7% of their pre-clozapine or pre-olanzapine weight were eligible for a 24-week, randomized, parallel group, double-blind comparison of adjunctive atomoxetine or placebo.
  
  
  RESULTS
  Thirty-seven participants (20 atomoxetine, 17 placebo) were randomized and 26 participants (14 atomoxetine, 12 placebo; 70.2%) completed the study. There were no significant group differences in baseline BMI (atomoxetine: 34.5±4.9; placebo: 35.7±7.0) or weight (atomoxetine: 102.2±15.7 kg; placebo: 104.3±17.5 kg). Both treatment groups showed modest, not significant, trends in weight loss, averaging about 2 kg. Gender or baseline antipsychotic treatment did not modify treatment effects on weight. Secondary outcomes included neuropsychological assessments, symptom assessments (BPRS, SANS) and safety assessments. Of these, only the group difference in Gordon distractibility test scores was statistically significant and favored treatment with atomoxetine.
  
  
  CONCLUSIONS
  Atomoxetine is not effective for weight loss in this population, but both olanzapine and clozapine participants can lose weight with structured group support and exercise.
authors: Maryland Psychiatric Research Center, University of Maryland School of Medicine,Catonsville, MD 21228, USA. pball@mprc.umaryland.edu
authors: M Patricia
authors: MP
authors: Ball
authors: Kimberly R
authors: KR
authors: Warren
authors: Stephanie
authors: S
authors: Feldman
authors: Robert P
authors: RP
authors: McMahon
authors: Deanna L
authors: DL
authors: Kelly
authors: Robert W
authors: RW
authors: Buchanan
mesh_terms: D018759:Adrenergic Uptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001067:Appetite Depressants / Q000627:therapeutic use*; D000069445:Atomoxetine Hydrochloride; D001288:Attention / Q000187:drug effects; D001569:Benzodiazepines / Q000009:adverse effects* / Q000627:therapeutic use; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects; D010054:Brief Psychiatric Rating Scale; D003024:Clozapine / Q000009:adverse effects* / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004038:Diet, Reducing; D004311:Double-Blind Method; D015444:Exercise; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008396:Maryland; D008875:Middle Aged; D009483:Neuropsychological Tests; D009765:Obesity / Q000139:chemically induced* / Q000188:drug therapy*; D000077152:Olanzapine; D011437:Propylamines / Q000009:adverse effects / Q000627:therapeutic use*; D011618:Psychotic Disorders / Q000188:drug therapy*; D012559:Schizophrenia / Q000188:drug therapy*
chemical_list: D018759:Adrenergic Uptake Inhibitors; D014150:Antipsychotic Agents; D001067:Appetite Depressants; D011437:Propylamines; D001569:Benzodiazepines; D000069445:Atomoxetine Hydrochloride; D003024:Clozapine; D000077152:Olanzapine