ANTIPSYCHOTIC TREATMENT AND WEIGHT GAIN: DOES RISPERIDONE BEHAVE DIFFERENTLY IN PAKISTANI PSYCHIATRIC PATIENTS?

Authors

  • Saleem Perwaiz Iqbal
  • Rashid AM Khan
  • Syed Ahmer

Abstract

Background: Studies from the Western world have shown that antipsychotic medications inpsychiatric patients result in weight gain and other metabolic diseases. This study was undertaken toinvestigate whether any one of the five most commonly prescribed antipsychotics, (risperidone,olanzepine, trifluoperazine, quetiapine and haloperidol) could behave differently in terms of causingweight gain among patients attending the psychiatric outpatient clinics in a tertiary care hospital inKarachi, Pakistan. Methods: For this retrospective cohort study, data were collected from outpatientrecords of the Aga Khan University Hospital, from 2003 to 2007. Demographic and clinical data wereanalysed. Repeated measures ANOVA, using a linear mixed model approach was used to assess weightgain over time due to the use of antipsychotic medications. Results: A total of 124 subject records (68males and 56 females) were evaluated. One-way ANOVA revealed that the groups being prescribedwith antipsychotics were comparable with respect to age, duration of treatment and weightmeasurements. Frequencies were calculated which showed that weight increases significantly over timewith respect to the prescribed antipsychotic medications, except for risperidone. Repeated measuresANOVA using the linear mixed model approach showed that the serial weight measurements weresignificantly different across the follow up times (p<0.05). Conclusion: Four of the commonlyprescribed antipsychotic drugs do result in an increase in weight; however risperidone has no sucheffect, making it an option in treating psychiatric disorders without worrying for any gain in weight. Inview of the increased prevalence of obesity and other metabolic diseases, measures should be takentowards careful prescription of antipsychotic medications.Keywords: Schizophrenia depression weight gain obesity antipsychotics risperidone

References

Bhugra D. The global prevalence of schizophrenia. PLoS Med

; 2(5):e151. quiz e75.

Muhammad Gadit AA, Mugford G. Prevalence of depression

among households in three capital cities of Pakistan: need to

revise the mental health policy. PLoS ONE 2007;2(2):e209.

Fleischhacker WW, Cetkovich-Bakmas M, De Hert M,

Hennekens CH, Lambert M, Leucht S, et al. Comorbid somatic

illnesses in patients with severe mental disorders: clinical, policy,

and research challenges. J Clin Psychiatry.2008;69:514–9.

Bernstein JG. Induction of obesity by psychotropic drugs. Ann N

Y Acad Sci 1987;499:203–15.

Ahmer S, Khan RA, Iqbal SP. Association between

antipsychotics and weight gain among psychiatric outpatients in

Pakistan: a retrospective cohort study. Ann Gen Psychiatry

;7:12.

Allison DB, Mentore JL, Heo M, Chandler LP, Cappelleri JC,

Infante MC, et al. Antipsychotic-induced weight gain: a

comprehensive research synthesis. Am J Psychiatry

;156:1686–96.

Taylor DM, McAskill R. Atypical antipsychotics and weight

gain--a systematic review. Acta Psychiatrica Scandinavica

;101:416–32.

Zipursky RB, Gu H, Green AI, Perkins DO, Tohen MF, McEvoy

JP, et al. Course and predictors of weight gain in people with

first-episode psychosis treated with olanzapine or haloperidol. Br

J Psychiatry 2005;187:537–43.

Brady CT. Weight gain associated with psychotropic drugs.

South Med J 1989;82:611–6.

Baptista T. Body weight gain induced by antipsychotic drugs:

mechanisms and management. Acta Psychiatrica Scandinavica

;100:3–16.

Blackburn GL. Weight gain and antipsychotic medication. J Clin

Psychiatry 2000;61(Suppl 8):36–41.

Bridler R, Umbricht D. Atypical antipsychotics in the treatment

of schizophrenia. Swiss Med Wkly 2003;133(5–6):63–76.

Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and

trends in obesity among US adults, 1999–2000. JAMA

;288:1723–7.

Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR,

Flegal KM. Prevalence of overweight and obesity among US

children, adolescents, and adults, 1999–2002. JAMA

;291:2847–50.

Allison DB, Fontaine KR, Heo M, Mentore JL, Cappelleri JC,

Chandler LP, et al. The distribution of body mass index among

individuals with and without schizophrenia. J Clin Psychiatry

;60:215–20.

Mukherjee S, Decina P, Bocola V, Saraceni F, Scapicchio PL.

Diabetes mellitus in schizophrenic patients. Compr Psychiatry

;37:68–73.

McKee HA, D’Arcy PF, Wilson PJ. Diabetes and schizophrenia–

a preliminary study. J Clin Hosp Pharm 1986;11:297–9.

Brambilla F, Guastalla A, Guerrini A, Riggi F, Rovere C,

Zanoboni A, et al. Glucose-insulin metabolism in chronic

schizophrenia. Dis Nerv Syst 1976;37(2):98–103.

Tsuang MT, Perkins K, Simpson JC. Physical diseases in

schizophrenia and affective disorder. J Clin Psychiatry

;44(2):42–6.

Jafar TH, Levey AS, Jafary FH, White F, Gul A, Rahbar MH, et

al. Ethnic subgroup difference in hypertension in Pakistan. J

Hypertens 2003;21:905–12.

Shera AS, Rafique G, Khawaja IA, Baqai S, King H. Pakistan

National Diabetes Survey: prevalence of glucose intolerance and

associated factors in Baluchistan province. Diabetes Res Clin

Pract 1999;44(1):49–58.

Shera AS, Rafique G, Khwaja IA, Baqai S, Khan IA, King H.

Pakistan National Diabetes Survey prevalence of glucose

intolerance and associated factors in North West at Frontier

Province (NWFP) of Pakistan. JPMA 1999;49(9):206–11.

Perez-Iglesias R, Mata I, Pelayo-Teran JM, Amado JA, GarciaUnzueta MT, Berja A, et al. Glucose and lipid disturbances after

year of antipsychotic treatment in a drug-naive population.

Schizophr Res 2009;107(2–3):115–21.

Hennekens CH. Increasing global burden of cardiovascular

disease in general populations and patients with schizophrenia. J

Clin Psychiatry 2007;68(Suppl 4):4–7.

Mumford DB, Saeed K, Ahmad I, Latif S, Mubbashar MH.

Stress and psychiatric disorder in rural Punjab. A community

survey. Br J Psychiatry 1997;170:473–8.

Ascher-Svanum H, Stensland M, Zhao Z, Kinon BJ. Acute

weight gain, gender, and therapeutic response to antipsychotics in

the treatment of patients with schizophrenia. BMC Psychiatry

;5:3.

Leucht S, Corves C, Arbter D, Engel RR, Li C, Davis JM.

Second-generation versus first-generation antipsychotic drugs for

schizophrenia: a meta-analysis. Lancet 2009;373(9657):31–41.

Kraus T, Haack M, Schuld A, Hinze-Selch D, Kuhn M, Uhr M,

et al. Body weight and leptin plasma levels during treatment with

antipsychotic drugs. Am J Psychiatry 1999;156:312–4.

American Diabetes Association APA, American Association of

Clinical Endocrinologists and North American Association for

the Study of Obesity. Consensus development conference on

antipsychotic drugs and obesity and diabetes. Diabetes Care

;27:596–601.

Chan YH. Biostatistics 301A. Repeated measurement analysis

(mixed models). Singapore Med J 2004;45:456–61.

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Published

2011-03-01