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Reversal of antipsychotic-associated weight gain.

Abstract

BACKGROUND

Given growing concern about weight gain associated with treatment with antipsychotic agents, we performed a retrospective chart review of patients who reversed weight gain associated with antipsychotic treatment to determine the prevalence of reversal and both the course and methods used.

METHOD

Prevalence of weight gain reversal was determined by surveying clinicians. Of 53 patients who gained >/= 20 lb (9 kg) during antipsychotic treatment, an initial sample of 12 patients (23%) who subsequently lost >/= 10 lb (5 kg) was identified. These 12 patients were combined with additional patients, identified by the authors, who met the same criteria for reversal of antipsychotic-associated weight gain to form a total sample of 35 patients. Course and methods of weight loss were determined by reviewing these patients' charts. Information about interventions and both antipsychotic and other medications was collected.

RESULTS

At the point of maximum weight gain, the total sample of 35 patients had gained a mean of 29.36 kg (64.73 lb) over a mean of 33 months. At the point of greatest weight loss (56 months), these patients were a mean of 10.86 kg (23.94 lb) over their baseline weight. The most recent weight for patients (63 months) indicated they were 14.81 kg (32.65 lb) over baseline. The most frequent weight loss interventions were regular dietician visits (42.9% [N = 15]), self-directed diet (28.6% [N = 10]), and weight loss as a treatment goal (25.7% [N = 9]). The least frequent interventions were no intervention (5.7% [N = 2]), psychiatrist addressing weight loss (5.7% [N = 2]), and surgery (2.9% [N = 1]). No significant change in medications prescribed was found.

CONCLUSION

Some patients who gain weight while taking antipsychotic medications are able to stop gaining and lose weight over time, largely through behavioral interventions. While patients' weight fluctuated, this group sustained a loss of approximately half their initial gain. Dietary interventions appear promising and should be explored further to prevent and reverse weight gain.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Mental Health Center of Greater Manchester, Manchester, N.H., USA. christopher.o'keefe@dartmouth.edu

    , ,

    Source

    The Journal of clinical psychiatry 64:8 2003 Aug pg 907-12

    MeSH

    Adult
    Antipsychotic Agents
    Behavior Therapy
    Bipolar Disorder
    Case Management
    Diet, Reducing
    Exercise
    Female
    Humans
    Male
    Obesity
    Psychotic Disorders
    Retrospective Studies
    Schizophrenia
    Weight Gain
    Weight Loss

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    12927005

    Citation

    O'Keefe, Christopher D., et al. "Reversal of Antipsychotic-associated Weight Gain." The Journal of Clinical Psychiatry, vol. 64, no. 8, 2003, pp. 907-12.
    O'Keefe CD, Noordsy DL, Liss TB, et al. Reversal of antipsychotic-associated weight gain. J Clin Psychiatry. 2003;64(8):907-12.
    O'Keefe, C. D., Noordsy, D. L., Liss, T. B., & Weiss, H. (2003). Reversal of antipsychotic-associated weight gain. The Journal of Clinical Psychiatry, 64(8), pp. 907-12.
    O'Keefe CD, et al. Reversal of Antipsychotic-associated Weight Gain. J Clin Psychiatry. 2003;64(8):907-12. PubMed PMID: 12927005.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Reversal of antipsychotic-associated weight gain. AU - O'Keefe,Christopher D, AU - Noordsy,Douglas L, AU - Liss,Thomas B, AU - Weiss,Honey, PY - 2003/8/21/pubmed PY - 2003/9/26/medline PY - 2003/8/21/entrez SP - 907 EP - 12 JF - The Journal of clinical psychiatry JO - J Clin Psychiatry VL - 64 IS - 8 N2 - BACKGROUND: Given growing concern about weight gain associated with treatment with antipsychotic agents, we performed a retrospective chart review of patients who reversed weight gain associated with antipsychotic treatment to determine the prevalence of reversal and both the course and methods used. METHOD: Prevalence of weight gain reversal was determined by surveying clinicians. Of 53 patients who gained >/= 20 lb (9 kg) during antipsychotic treatment, an initial sample of 12 patients (23%) who subsequently lost >/= 10 lb (5 kg) was identified. These 12 patients were combined with additional patients, identified by the authors, who met the same criteria for reversal of antipsychotic-associated weight gain to form a total sample of 35 patients. Course and methods of weight loss were determined by reviewing these patients' charts. Information about interventions and both antipsychotic and other medications was collected. RESULTS: At the point of maximum weight gain, the total sample of 35 patients had gained a mean of 29.36 kg (64.73 lb) over a mean of 33 months. At the point of greatest weight loss (56 months), these patients were a mean of 10.86 kg (23.94 lb) over their baseline weight. The most recent weight for patients (63 months) indicated they were 14.81 kg (32.65 lb) over baseline. The most frequent weight loss interventions were regular dietician visits (42.9% [N = 15]), self-directed diet (28.6% [N = 10]), and weight loss as a treatment goal (25.7% [N = 9]). The least frequent interventions were no intervention (5.7% [N = 2]), psychiatrist addressing weight loss (5.7% [N = 2]), and surgery (2.9% [N = 1]). No significant change in medications prescribed was found. CONCLUSION: Some patients who gain weight while taking antipsychotic medications are able to stop gaining and lose weight over time, largely through behavioral interventions. While patients' weight fluctuated, this group sustained a loss of approximately half their initial gain. Dietary interventions appear promising and should be explored further to prevent and reverse weight gain. SN - 0160-6689 UR - https://www.unboundmedicine.com/medline/citation/12927005/full_citation L2 - http://www.psychiatrist.com/jcp/article/pages/2003/v64n08/v64n0808.aspx DB - PRIME DP - Unbound Medicine ER -