Friday, 11 June 2010

Weight gain and antipsychotics

The weight gain from quetapine can be pretty bad. I'm not sure if it's
my physiology though. When I was on quetapine I rose to a 38 inch waist
line. I'm somewhere between 30-32 now.

http://ajp.psychiatryonline.org/cgi/reprint/156/11/1686 (full paper
available)
Antipsychotic-Induced Weight Gain: A Comprehensive Research Synthesis
David B. Allison, Ph.D., Janet L. Mentore, M.S.Ed., Moonseong Heo,
Ph.D., Linda P. Chandler, Ph.D., Joseph C. Cappelleri, Ph.D., M.P.H.,
Ming C. Infante, M.S., and Peter J. Weiden, M.D.
Am J Psychiatry 156:1686-1696, November 1999

OBJECTIVE: The purpose of this study was to estimate and compare the
effects of anti­psychotics—both the newer ones and the conventional
ones—on body weight. METHOD: A comprehensive literature search
identified 81 English- and non-English-language articles that included
data on weight change in antipsychotic-treated patients. For each agent,
a meta-analysis and random effects metaregression estimated the weight
change after 10 weeks of treatment at a standard dose. A comprehensive
narrative review was also conducted on all articles that did not yield
quantitative information but did yield important qualitative
information. RESULTS: Placebo was associated with a mean weight
reduction of 0.74 kg. Among conventional agents, mean weight change
ranged from a reduction of 0.39 kg with molindone to an increase of 3.19
kg with thioridazine. Among newer antipsychotic agents, mean increases
were as follows: clozapine, 4.45 kg; olanzapine, 4.15 kg; sertindole,
2.92 kg; risperidone, 2.10 kg; and ziprasidone, 0.04 kg. Insufficient
data were available to evaluate quetiapine at 10 weeks. CONCLUSIONS:
Both conventional and newer anti psychotics are associated with weight
gain. Among the newer agents, clozapine appears to have the greatest
potential to induce weight gain, and ziprasidone the least. The
differences among newer agents may affect compliance with medication and
health risk.

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