title: The effects of antipsychotics on weight gain, weight-related hormones and homocysteine in children and adolescents: a 1-year follow-up study.
abstract: To analyze weight gain, metabolic hormones, and homocysteine (Hcys) levels in children and adolescents on antipsychotics (AP) during a year-long follow-up. 117 patients, AP-naïve or quasi-naïve (less than 30 days on AP), were included. Weight, body mass index (BMI), BMI z-score (z-BMI), and levels of leptin, insulin, insulin resistance (HOMA-IR), adiponectin, ghrelin, thyroid stimulating hormone (TSH), free thyroxine (FT4), and Hcys were measured at baseline, and at 3, 6, and 12 months, while patients remained on the same AP. Patients (mean age: 14.4 ± 3 years; 64.1 % male) were on risperidone (N = 84), olanzapine (N = 20) or quetiapine (N = 13) from baseline up to 1-year follow-up and significantly increased weight (5.8 ± 4.3 kg at 3-month, 8.1 ± 6.1 kg at 6-month, and 11.6 ± 7.0 kg at 1 year), BMI, and z-BMI. Leptin levels significantly increased from baseline to 3 and 6 months, as did TSH levels from baseline to 3 months, while FT4 levels decreased from baseline to 3 and 6 months. Patients with BMI >85th percentile at baseline (N = 16) significantly increased weight, BMI, and z-BMI, more than patients with normal BMI over time. Higher baseline levels of insulin, HOMA-IR, and leptin were associated with increased weight/BMI during follow-up, while higher baseline levels of FT4, adiponectin, and ghrelin were associated with lower weight/BMI during follow-up. All AP were associated with increased weight and BMI/z-BMI in all of the assessments; however, at 1-year assessment, this increase was significantly higher for patients on quetiapine. Both higher baseline levels of insulin, HOMA-IR, and leptin, as well as being overweight/obese at baseline were associated with increased weight/BMI during 1-year follow-up in children and adolescents on AP. Awareness of weight-related parameters in this population may help inform decisions regarding AP prescriptions.
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Institut Clinic of Neurosciences, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi Sunyer), Hospital Clínic Universitari of Barcelona, Villarroel, 170, Barcelona, 08036, Spain. ibaeza@clinic.ub.es.|Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain. ibaeza@clinic.ub.es.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Baeza
authors.affiliation: Adolescent Service, Mapther house, Maudsley Hospital, London, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Vigo
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Institut Clinic of Neurosciences, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi Sunyer), Hospital Clínic Universitari of Barcelona, Villarroel, 170, Barcelona, 08036, Spain.|Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: de la Serna
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Institut Clinic of Neurosciences, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi Sunyer), Hospital Clínic Universitari of Barcelona, Villarroel, 170, Barcelona, 08036, Spain.|Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Calvo-Escalona
authors.affiliation: Child and adolescent Psychiatry Department, School of Medicine, Hospital General Universitario Gregorio Marañón, Universidad Complutense, IISGM, CIBERSAM, Madrid, Spain.
authors.forename: Jessica
authors.initials: J
authors.lastname: Merchán-Naranjo
authors.affiliation: Child and adolescent Psychiatry Department, School of Medicine, Hospital General Universitario Gregorio Marañón, Universidad Complutense, IISGM, CIBERSAM, Madrid, Spain.
authors.forename: Pamela
authors.initials: P
authors.lastname: Rodríguez-Latorre
authors.affiliation: Child and adolescent Psychiatry Department, School of Medicine, Hospital General Universitario Gregorio Marañón, Universidad Complutense, IISGM, CIBERSAM, Madrid, Spain.
authors.forename: Celso
authors.initials: C
authors.lastname: Arango
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Institut Clinic of Neurosciences, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi Sunyer), Hospital Clínic Universitari of Barcelona, Villarroel, 170, Barcelona, 08036, Spain.|Department of Psychiatry and Psychobiology, University of Barcelona, Barcelona, Spain.|Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
authors.forename: Josefina
authors.initials: J
authors.lastname: Castro-Fornieles
mesh_terms: D000293:Adolescent; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D001835:Body Weight / Q000187:drug effects / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D054439:Ghrelin / Q000097:blood; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007328:Insulin / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D009765:Obesity / Q000097:blood* / Q000139:chemically induced* / Q000175:diagnosis; D000077152:Olanzapine; D011446:Prospective Studies; D018967:Risperidone / Q000009:adverse effects / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D015430:Weight Gain / Q000187:drug effects* / Q000502:physiology*
chemical_list: D014150:Antipsychotic Agents; D054439:Ghrelin; D007328:Insulin; D020738:Leptin; D006710:Homocysteine; D001569:Benzodiazepines; D018967:Risperidone; D000077152:Olanzapine
keywords: Adolescents; Antipsychotic; Children; Side effects; Weight gain