Psychotropic drug-induced weight gain and other metabolic complications in a Swiss psychiatric population.
OBJECTIVE
To describe the weight gain-related side-effects of psychotropic drugs and their consequences on metabolic complications (hypercholesterolemia, obesity) in a Swiss cohort of psychiatric patients.


METHODS
This cross-sectional observational study was performed in an out-patient psychiatric division with patients having received for more than 3 months the following drugs: clozapine, olanzapine, quetiapine, risperidone, lithium, and/or valproate. Clinical measures and lifestyle information (smoking behaviour, physical activity) were recorded.


RESULTS
196 inclusions were completed. Weight gain (≥10% of initial weight) following drug treatment was reported in 47% of these patients. Prevalence of obesity (BMI ≥ 30), hypercholesterolemia (≥6.2 mmol/L) and low HDL-cholesterol (<1.0 mmol/L in men, <1.3 mmol/L in women) were present in 38%, 21%, and 27% of patients, respectively. A higher standardised dose, an increase of appetite following medication introduction, the type of medication (clozapine or olanzapine > quetiapine or risperidone > lithium or valproate), and the gender were shown to be significantly associated with evolution of BMI.


CONCLUSIONS
High prevalence of obesity and hypercholesterolemia was found in an out-patient psychiatric population and confirms drug-induced weight gain complications during long-term treatment. The results support the recently published recommendations of monitoring of metabolic side-effects during treatment with atypical antipsychotics. Moreover, the weight gain predictors found in the present study could help to highlight patients with special health care management requirement.
Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, University Hospital Centre and University of Lausanne, Prilly, Lausanne, Switzerland.
Eva
E
Choong
Guido
G
Bondolfi
Manuela
M
Etter
Françoise
F
Jermann
Jean-Michel
JM
Aubry
Javier
J
Bartolomei
Mehdi
M
Gholam-Rezaee
Chin B
CB
Eap
D000293:Adolescent; D000328:Adult; D000368:Aged; D001066:Appetite / Q000187:drug effects; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000139:chemically induced* / Q000453:epidemiology; D015995:Prevalence; D011619:Psychotropic Drugs / Q000009:adverse effects*; D018709:Statistics, Nonparametric; D013557:Switzerland / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
D011619:Psychotropic Drugs