Antipsychotic-induced body weight gain: Predictors and a systematic categorization of the long-term weight course

• Published in: Journal of psychiatric research Vol. 43; no. 6; pp. 620 - 626
• Main Authors: Gebhardt, Stefan, Haberhausen, Michael, Heinzel-Gutenbrunner, Monika, Gebhardt, Nadine, Remschmidt, Helmut, Krieg, Jürgen-Christian, Hebebrand, Johannes, Theisen, Frank M
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-03-2009
• Subjects: Adolescent; Adult; Age Factors; Analysis of Variance; Antipsychotic Agents - adverse effects; Antipsychotic Agents - therapeutic use; Antipsychotic drugs; Antipsychotics; Benzodiazepines - adverse effects; Benzodiazepines - therapeutic use; Body Mass Index; Body weight; Body Weight - drug effects; Body weight gain; Clozapine - adverse effects; Clozapine - therapeutic use; Cross-Sectional Studies; Female; Humans; Long-term; Male; Middle Aged; Parents; Predictors; Premorbid; Psychiatry; Retrospective Studies; Risk Factors; Risperidone - adverse effects; Risperidone - therapeutic use; Sex Factors; Smoking; Time Factors; Weight Gain - drug effects; Young Adult; Non-schizophrenia group; Body mass index (kg/m 2); Parents; Long-term; SCZ; Body weight gain; Schizophrenia group; Antipsychotics; Body mass index; NSCZ; BMI; Predictors; Premorbid
• ISSN: 0022-3956; 1879-1379
• DOI: 10.1016/j.jpsychires.2008.11.001

Abstract Objective To explore the impact of premorbid and baseline body mass indices (BMIs) as well as BMI of patient’s parents and associated variables on the prediction of antipsychotic-induced body weight gain. Methods Retrospective/cross-sectional data of 65 patients receiving clozapine, olanzapine and/or risperidone were assessed according to a systematic categorization of the long-term (7.3 ± 9.2 years) weight course and evaluated using descriptive, explorative correlation and regression analyses. Results Increased values of parents’ BMI ( p = 0.041) and patients’ BMI at premorbid stage ( p = 0.039) and prior to first antipsychotic treatment ( p = 0.032) as well as female gender ( p = 0.012), younger age ( p = 0.005) and non-smoking ( p = 0.047) have the most predictive value on body weight gain under antipsychotic treatment including pre-treatment with typical antipsychotics. Weight gain under atypical antipsychotics (pre-treatment excluded) is predicted by an increased premorbid BMI ( p = 0.019). Conversely, a low BMI prior to first antipsychotic treatment predicts a higher acceleration of BMI change ( p = 0.008) in vulnerable individuals, but not total BMI change itself. Furthermore, a diagnosis of a schizophrenia spectrum disorder showed a trend towards the prediction of an increased atypical ΔBMI ( p = 0.067), possibly due to a longer treatment duration with atypical antipsychotics ( p < 0.001). Discussion The study indicates increased parents’ BMI and patients’ premorbid BMI, female gender, younger age and – as a trend – the diagnosis of a schizophrenia spectrum disorder to be predictors for antipsychotic-induced body weight gain involving atypical antipsychotics. Data contribute to the assumption of a strong impact of predispositional factors on weight gain, besides treatment-related factors.