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Novel antipsychotics: comparison of weight gain liabilities.
J Clin Psychiatry. 1999 Jun; 60(6):358-63.JC

Abstract

BACKGROUND

We performed a retrospective analysis of 122 clinical records of 92 male patients with DSM-III-R schizophrenia to examine the relative weight gain liabilities of clozapine, risperidone, olanzapine, and sertindole compared with haloperidol. We hypothesized that the unique pharmacodynamic profiles of these agents would contribute to different amounts and patterns of weight gain.

METHOD

Data were analyzed to determine differences in weight gain during treatment among patients receiving 5 different drug treatments (clozapine [N = 20], olanzapine [N = 13], risperidone [N = 38], haloperidol [N = 43], and sertindole [N = 8]). Measures of maximal weight gain, final weight, and duration to maximal weight gain were calculated.

RESULTS

Repeated measures analyses of variance controlling for age, treatment duration, and initial weight revealed statistically significant differences between groups on all 3 measures. Clozapine and olanzapine had the greatest maximal weight gain liability (F = 4.13, df = 4,23; p = .01). Weight gain with clozapine, but not olanzapine or risperidone, appears to persist (as reflected by final weight) despite behavioral interventions (e.g., nutritional consultation, suggested exercise regimen; F = 5.69, df = 4,23; p = .003). Clozapine- and olanzapine-treated subjects appeared to gain weight over a prolonged period of time, whereas risperidone-and sertindole-treated subjects had a more limited period of weight gain (F = 2.95, df = 4,25; p = .04).

CONCLUSION

Clozapine and olanzapine caused the most weight gain, risperidone was intermediate, and sertindole had less associated weight gain than haloperidol. The relative receptor affinities of the novel antipsychotics for histamine H1 appear to be the most robust correlate of these clinical findings.

Authors+Show Affiliations

Department of Psychiatry, V.A. Greater Los Angeles Healthcare System, CA 90073, USA. ames@ucla.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

10401912

Citation

Wirshing, D A., et al. "Novel Antipsychotics: Comparison of Weight Gain Liabilities." The Journal of Clinical Psychiatry, vol. 60, no. 6, 1999, pp. 358-63.
Wirshing DA, Wirshing WC, Kysar L, et al. Novel antipsychotics: comparison of weight gain liabilities. J Clin Psychiatry. 1999;60(6):358-63.
Wirshing, D. A., Wirshing, W. C., Kysar, L., Berisford, M. A., Goldstein, D., Pashdag, J., Mintz, J., & Marder, S. R. (1999). Novel antipsychotics: comparison of weight gain liabilities. The Journal of Clinical Psychiatry, 60(6), 358-63.
Wirshing DA, et al. Novel Antipsychotics: Comparison of Weight Gain Liabilities. J Clin Psychiatry. 1999;60(6):358-63. PubMed PMID: 10401912.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Novel antipsychotics: comparison of weight gain liabilities. AU - Wirshing,D A, AU - Wirshing,W C, AU - Kysar,L, AU - Berisford,M A, AU - Goldstein,D, AU - Pashdag,J, AU - Mintz,J, AU - Marder,S R, PY - 1999/7/13/pubmed PY - 1999/7/13/medline PY - 1999/7/13/entrez SP - 358 EP - 63 JF - The Journal of clinical psychiatry JO - J Clin Psychiatry VL - 60 IS - 6 N2 - BACKGROUND: We performed a retrospective analysis of 122 clinical records of 92 male patients with DSM-III-R schizophrenia to examine the relative weight gain liabilities of clozapine, risperidone, olanzapine, and sertindole compared with haloperidol. We hypothesized that the unique pharmacodynamic profiles of these agents would contribute to different amounts and patterns of weight gain. METHOD: Data were analyzed to determine differences in weight gain during treatment among patients receiving 5 different drug treatments (clozapine [N = 20], olanzapine [N = 13], risperidone [N = 38], haloperidol [N = 43], and sertindole [N = 8]). Measures of maximal weight gain, final weight, and duration to maximal weight gain were calculated. RESULTS: Repeated measures analyses of variance controlling for age, treatment duration, and initial weight revealed statistically significant differences between groups on all 3 measures. Clozapine and olanzapine had the greatest maximal weight gain liability (F = 4.13, df = 4,23; p = .01). Weight gain with clozapine, but not olanzapine or risperidone, appears to persist (as reflected by final weight) despite behavioral interventions (e.g., nutritional consultation, suggested exercise regimen; F = 5.69, df = 4,23; p = .003). Clozapine- and olanzapine-treated subjects appeared to gain weight over a prolonged period of time, whereas risperidone-and sertindole-treated subjects had a more limited period of weight gain (F = 2.95, df = 4,25; p = .04). CONCLUSION: Clozapine and olanzapine caused the most weight gain, risperidone was intermediate, and sertindole had less associated weight gain than haloperidol. The relative receptor affinities of the novel antipsychotics for histamine H1 appear to be the most robust correlate of these clinical findings. SN - 0160-6689 UR - https://www.unboundmedicine.com/medline/citation/10401912/Novel_antipsychotics:_comparison_of_weight_gain_liabilities_ L2 - http://www.psychiatrist.com/jcp/article/pages/1999/v60n06/v60n0602.aspx DB - PRIME DP - Unbound Medicine ER -