Association of birth weight and the development of antipsychotic induced adiposity in individuals with treatment resistant schizophrenia.
Though weight gain is a common side effect of antipsychotic treatment, there are no useful predictors of which patients are likely to be affected and to what degree. It has been shown that exposure to adverse conditions during intra-uterine life confers a vulnerability to the development of later life metabolic complications and low birth weight for gestational age has been shown to be a robust marker of such prenatal adversity. We hypothesised that patients with schizophrenia with a lower birth weight will have increased vulnerability to the weight inducing effects of antipsychotic treatment. The relationship between birth weight and total and central adiposity, measured as body mass index (BMI) and waist-to-hip ratio (WHR) respectively, was examined in three groups: drug naïve first episode of psychosis (FEP) patients (n=41), treatment resistant schizophrenia (TRS) patients (n=42) and matched healthy volunteers (n=72). All analyses were controlled for age, gender and duration of treatment exposure. We found that a lower birth weight was associated with higher BMI and WHR only in TRS patients but not in FEP or controls, suggesting that prenatal adversity, as indicated by the surrogate marker of a lower birth weight, confers an increased vulnerability to clozapine induced weight gain.
Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0SZ, UK; Cambridgeshire and Peterborough Foundation Trust, Fulbourn Hospital, Cambridge CB21 5EF, UK; University of Cambridge Metabolic Research Laboratories and MRC Metabolic Diseases Unit, Institute of Metabolic Science, CB2 0QQ UK.
Hisham
H
Ziauddeen
Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona and Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Institut d׳Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain.
Clemente
C
Garcia-Rizo
Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona and Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Institut d׳Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain.
Miquel
M
Bernardo
Department of Psychiatry & Behavioral Sciences, University of Nevada School of Medicine, Reno, NV, United States.
Brian
B
Kirkpatrick
University of Cambridge Metabolic Research Laboratories and MRC Metabolic Diseases Unit, Institute of Metabolic Science, CB2 0QQ UK.
Susan E
SE
Ozanne
Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0SZ, UK; Cambridgeshire and Peterborough Foundation Trust, Fulbourn Hospital, Cambridge CB21 5EF, UK.
Peter B
PB
Jones
Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0SZ, UK; Cambridgeshire and Peterborough Foundation Trust, Fulbourn Hospital, Cambridge CB21 5EF, UK; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain. Electronic address: ef280@cam.ac.uk.
Emilio
E
Fernandez-Egea
D050154:Adiposity / Q000187:drug effects; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001724:Birth Weight; D015992:Body Mass Index; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000150:complications* / Q000188:drug therapy; D049629:Waist-Hip Ratio; D015430:Weight Gain / Q000187:drug effects; D055815:Young Adult
D014150:Antipsychotic Agents
Birth weight; Clozapine; Developmental programming; First episode psychosis; Schizophrenia; Weight gain