title: Importance of early weight changes to predict long-term weight gain during psychotropic drug treatment.
abstract: BACKGROUND
  Psychotropic drugs can induce substantial weight gain, particularly during the first 6 months of treatment. The authors aimed to determine the potential predictive power of an early weight gain after the introduction of weight gain-inducing psychotropic drugs on long-term weight gain.
  
  
  METHODS
  Data were obtained from a 1-year longitudinal study ongoing since 2007 including 351 psychiatric (ICD-10) patients, with metabolic parameters monitored (baseline and/or 1, 3, 6, 9, 12 months) and with compliance ascertained. International Diabetes Federation and World Health Organization definitions were used to define metabolic syndrome and obesity, respectively.
  
  
  RESULTS
  Prevalences of metabolic syndrome and obesity were 22% and 17%, respectively, at baseline and 32% and 24% after 1 year. Receiver operating characteristic analyses indicated that an early weight gain > 5% after a period of 1 month is the best predictor for important long-term weight gain (≥ 15% after 3 months: sensitivity, 67%; specificity, 88%; ≥ 20% after 12 months: sensitivity, 47%; specificity, 89%). This analysis identified most patients (97% for 3 months, 93% for 12 months) who had weight gain ≤ 5% after 1 month as continuing to have a moderate weight gain after 3 and 12 months. Its predictive power was confirmed by fitting a longitudinal multivariate model (difference between groups in 1 year of 6.4% weight increase as compared to baseline, P = .0001).
  
  
  CONCLUSIONS
  Following prescription of weight gain-inducing psychotropic drugs, a 5% threshold for weight gain after 1 month should raise clinician concerns about weight-controlling strategies.
authors.affiliation: Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Hospital of Cery, Prilly, Switzerland.
authors.forename: Frederik
authors.initials: F
authors.lastname: Vandenberghe
authors.forename: Mehdi
authors.initials: M
authors.lastname: Gholam-Rezaee
authors.forename: Núria
authors.initials: N
authors.lastname: Saigí-Morgui
authors.forename: Aurélie
authors.initials: A
authors.lastname: Delacrétaz
authors.forename: Eva
authors.initials: E
authors.lastname: Choong
authors.forename: Alessandra
authors.initials: A
authors.lastname: Solida-Tozzi
authors.forename: Stéphane
authors.initials: S
authors.lastname: Kolly
authors.forename: Jacques
authors.initials: J
authors.lastname: Thonney
authors.forename: Sylfa Fassassi
authors.initials: SF
authors.lastname: Gallo
authors.forename: Ahmed
authors.initials: A
authors.lastname: Hedjal
authors.forename: Anne-Emmanuelle
authors.initials: AE
authors.lastname: Ambresin
authors.forename: Armin
authors.initials: A
authors.lastname: von Gunten
authors.forename: Philippe
authors.initials: P
authors.lastname: Conus
authors.forename: Chin B
authors.initials: CB
authors.lastname: Eap
mesh_terms: D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects*; D018692:Antimanic Agents / Q000009:adverse effects*; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001835:Body Weight / Q000187:drug effects; D015897:Comorbidity; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D050177:Overweight / Q000453:epidemiology; D011379:Prognosis; D011619:Psychotropic Drugs / Q000009:adverse effects*; D013997:Time Factors; D015430:Weight Gain / Q000187:drug effects*
chemical_list: D000929:Antidepressive Agents, Tricyclic; D018692:Antimanic Agents; D014150:Antipsychotic Agents; D011619:Psychotropic Drugs