Weight loss in overweight patients maintained on atypical antipsychotic agents

Weight gain and associated medical morbidity offset the reduction of extrapyramidal side effects associated with atypical antipsychotics. Efforts to control weight in antipsychotic-treated patients have yielded limited success. We studied the impact of an intensive 24-week program of diet, exercise,...

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Bibliographic Details
Published in:	International Journal of Obesity Vol. 30; no. 6; pp. 1011 - 1016
Main Authors:	CENTORRINO, F, WURTMAN, J. J, BALDESSARINI, R. J, DUCA, K. A, FELLMAN, V. H, FOGARTY, K. V, BERRY, J. M, GUAY, D. M, ROMELING, M, KIDWELL, J, CINCOTTA, S. L
Format:	Journal Article
Language:	English
Published:	Basingstoke Nature Publishing 01-06-2006 Nature Publishing Group
Subjects:	Adult Adult and adolescent clinical studies Antipsychotic Agents - adverse effects Antipsychotics Biological and medical sciences Blood Pressure Body Mass Index Body weight Calories Cholesterol Chronic Disease Combined Modality Therapy Counseling Diet Diet, Reducing Exercise Feeding. Feeding behavior Female Fundamental and applied biological sciences. Psychology Humans Male Medical sciences Metabolic diseases Middle Aged Morbidity Neurosciences Obesity Obesity - chemically induced Obesity - physiopathology Obesity - therapy Overweight Overweight - drug effects Program Evaluation Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Psychoses Psychotic Disorders - drug therapy Psychotic Disorders - physiopathology Psychotropic drugs Schizophrenia Schizophrenia - drug therapy Schizophrenia - physiopathology Side effects Treatment Outcome Vertebrates: anatomy and physiology, studies on body, several organs or systems Weight control Weight Loss United States > US Schizoaffective psychosis Atypical antipsychotic Neuroleptic Psychotropic Toxicity Body weight Schizophrenia exercise Overweight Psychosis antipsychotic Nutritional status Public health schizoaffective disorder Human Obesity Nutrition Nutrition disorder Weight loss Patient Metabolic diseases Recommendation Feeding conditioning diet Chemotherapy Treatment
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Summary:	Weight gain and associated medical morbidity offset the reduction of extrapyramidal side effects associated with atypical antipsychotics. Efforts to control weight in antipsychotic-treated patients have yielded limited success. We studied the impact of an intensive 24-week program of diet, exercise, and counseling in 17 chronically psychotic patients (10 women, seven men) who entered at high average body weight (105.0+/-18.4 kg) and body mass index (BMI) (36.6+/-4.6 kg/m(2)). A total of 12 subjects who completed the initial 24 weeks elected to participate in an additional 24-week, less intensive extension phase. By 24 weeks, weight-loss/patient averaged 6.0 kg (5.7%) and BMI decreased to 34.5 (by 5.7%). Blood pressure decreased from 130/83 to 116/74 (11% improvement), pulse fell slightly, and serum cholesterol and triglyceride concentrations changed nonsignificantly. With less intensive management for another 24 weeks, subjects regained minimal weight (0.43 kg). These findings add to the emerging view that weight gain is a major health problem associated with modern antipsychotic drugs and that labor-intensive weight-control efforts in patients requiring antipsychotic treatment yield clinically promising benefits. Improved treatments without weight-gain risk are needed.
ISSN:	0307-0565 1476-5497
DOI:	10.1038/sj.ijo.0803222