title: Olanzapine-induced weight gain plays a key role in the potential cardiovascular risk: evidence from heart rate variability analysis.
abstract: Patients with schizophrenia have a higher risk for cardiovascular disease (CVD) than the general population. Research has suggested that autonomic imbalance is a common pathway to increased morbidity and mortality for CVD. Heart rate variability (HRV) analysis is a non-invasive method that assesses autonomic imbalance, and low HRV is correlated with high cardiovascular risk. Olanzapine, a widely used antipsychotic drug, is considered to have good cardiac safety because of not causing significant corrected QT-interval (QTc) prolongation; however, it is still unclear whether olanzapine affects HRV. We recruited 83 patients with schizophrenia who were medication-free for at least 1 month and tested their HRV at the baseline and 4 weeks after treatment with olanzapine. We found that patients who had substantial weight gain (EWG) manifested significantly lower HRV than those who had non-substantial weight gain (NWG) and that HRV decrease was positively correlated to an increase in body mass index (BMI) and weight gain. Our results indicate that olanzapine-induced weight gain may play an important role in its potential cardiovascular risk. Since olanzapine has a very high potential for weight gain compared with other antipsychotics, further research is needed to explore its cardiovascular safety profile, specifically long-term cardiac safety.
authors.affiliation: Department of Clinical Psychiatry, Wuxi Mental Health Center affiliated to Nanjing Medical University, Wuxi 214151, Jiangsu Province, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Clinical Psychology, Wuxi Mental Health Center affiliated to Nanjing Medical University, Wuxi 214151, Jiangsu Province, China.
authors.forename: Yan-song
authors.initials: YS
authors.lastname: Liu
authors.affiliation: Department of Clinical Psychiatry, Wuxi Mental Health Center affiliated to Nanjing Medical University, Wuxi 214151, Jiangsu Province, China.
authors.forename: Wen-xian
authors.initials: WX
authors.lastname: Zhu
authors.affiliation: Department of Clinical Psychology, Wuxi Mental Health Center affiliated to Nanjing Medical University, Wuxi 214151, Jiangsu Province, China.
authors.forename: Fu-quan
authors.initials: FQ
authors.lastname: Zhang
authors.affiliation: Department of Clinical Psychiatry, Wuxi Mental Health Center affiliated to Nanjing Medical University, Wuxi 214151, Jiangsu Province, China.
authors.forename: Zhen-he
authors.initials: ZH
authors.lastname: Zhou
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects* / Q000627:therapeutic use; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology*; D002681:China / Q000453:epidemiology; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D008297:Male; D000077152:Olanzapine; D012307:Risk Factors; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D015430:Weight Gain / Q000187:drug effects*
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000077152:Olanzapine; D017367:Selective Serotonin Reuptake Inhibitors