Antipsychotic drugs obesity/weight gain

Vieweg WV, Sood AB, Pandurangi A, Silverman JJ. Newer antipsychotic drugs and obesity in children and adolescents. How should we assess drug-associated weight gain Acta Psychiatr Scand 2005 111 177-84. 

The incidence rates for six categories of adverse events of antipsychotic drug use have been compared in a retrospective cohort study of 4140 children and adolescents (mean age 10 years) and 4500 children (mean age 7.2 years) with similar service encounters but not treated with psychotropic drugs /(5 7- Six atypical and two conventional antipsychotic drugs were studied. The overall incidence/prevalence rates in the control and treated groups differed dramatically in obesity/weight gain (8.6% versus 20%), type 2 diabetes (1.9% versus... 

Metabolic and cardiovascular adverse events were further studied by the same authors in the same sample of children and adolescents [7 ]. Compared with the controls, the treated cohort had a higher prevalence of obesity (OR = 2.1), type 2 diabetes mellitus (OR = 3.2), cardiovascular conditions (OR = 2.7), and orthostatic hypotension (OR = 1.6). In the treated cohort, those who had been exposed to multiple antipsychotic drugs had a significantly higher risk of incident obesity/weight gain (OR = 2.3), type 2 diabetes mellitus (OR = 2.4), and dyslipidemia (OR = 5.3). Incident cardiovascular events were more likely with the use of conventional antipsychotic drugs (OR = 4.3) and mood stabilizers (OR = 1.3). Incident orthostatic hypotension h os more prevalent in those co-prescribed selective serotonin reuptake inhibitors (OR = 1.8) and mood stabilizers (OR = 1.3). 

A thorough search for studies that addressed obesity in children and adolescents in relation to the new antipsychotic drugs showed that risperidone is associated with less weight gain than olanzapine (824). 

Allison, D. B. and D. E. Casey (2001). Antipsychotic-induced weight gain a review of the literature. J Clin Psychiatry 62(Suppl 7) 22-31. Anttila, S. A. and E. V. Leinonen (2001). A review of the pharmacological and clinical profile of mirtazapine. CNS Drug Rev 7(3) 249-64. Baptista, T., N. M. Kin, S. Beaulieu and E. A. de Baptista (2002). Obesity and related metabolic abnormalities during antipsychotic drug administration mechanisms, management and research perspectives. Pharmacopsychiatry. 35(6) 205-19. 

Olanzapine/weight gain LEP- and LEPR 200 LEPR Q223R polymorphism may be associated with obesity in women with a psychotic disorder treated with atypical antipsychotic drugs [471... 

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