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Management of antipsychotic-induced weight gain: prospective naturalistic study of the effectiveness of a supervised exercise programme.
Aust N Z J Psychiatry. 2007 Dec; 41(12):980-9.AN

Abstract

OBJECTIVE

To determine the potential effectiveness of a behavioural weight control programme including physical exercise in the prevention of antipsychotic-induced weight gain and associated comorbid conditions in outpatients with schizophrenia and mood disorders.

METHODS

A prospective, comparative, open and naturalistic study was carried out for a total of 110 patients with schizophrenia, schizoaffective or bipolar disorders (DSM-IV), on treatment with atypical antipsychotics. Of these, 59 patients participated in an 18 month weight control programme that included an educational activity about dietary and physical activity counselling as well as a structured, supervised, facility-based exercise programme. The control group consisted of 51 patients with the same baseline characteristics who did not receive the clinical programme. Anthropometric measurements, plasma lipid-lipoprotein profile, and fasting plasma glucose concentrations were assessed at 11 time-points over the study. In addition, serum concentrations of prolactin, thyrotropin-stimulating hormone (TSH), and glycated haemoglobin (HbA1c) were assessed at four time-points. Finally, the Clinical Global Impression scale (CGI), the Brief Psychiatric Rating Scale (BPRS) and the Short Form (SF)-36 Health Survey were used.

RESULTS

The adherence rate of patients was 85%, both in the active and in the control group. Whereas the control group experienced a significant increase in bodyweight (4.1%), body mass index (BMI; 5.5%) and waist circumference (WC; 4.2%), the active group significantly reduced their bodyweight (-3.5%), BMI (-4.4%), and WC (-4.6%) at the study end-point. In addition, a significant increase in low-density lipoprotein (LDL)-cholesterol (14.8%) and in triglyceride concentrations (12.3%) was observed at month 18 in the control group. In contrast, high-density lipoprotein-cholesterol (HDL) significantly increased (21.4%), and LDL cholesterol (-13.7%), triglycerides (-26.2%), total cholesterol (-12.1%), fasting glucose concentrations (-12.0%), and HbA1c (-11.4%) significantly decreased compared to baseline in the active group. No significant changes were observed regarding serum concentrations of prolactin and TSH during the study. In regard to the changes observed in psychological measures, no between-group differences were seen in the clinical ratings of CGI and BPRS. However, the SF-36 showed that physical health was improved only for subjects in the active group at months 12 and 18 compared to baseline (p<0.05), and mental health was significantly improved for both groups at months 12 and 18 compared to baseline.

CONCLUSION

Bodyweight and metabolic risk profile in patients receiving atypical antipsychotic medications can be effectively managed with a weight control programme including physical activity.

Authors+Show Affiliations

Centre Hospitalier Affilié Universitaire de Québec, Hôpital de l'Enfant-Jésus and Centre Hospitalier Robert-Giffard, Quebec City, Quebec, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo 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
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17999270

Citation

Poulin, Marie-Josée, et al. "Management of Antipsychotic-induced Weight Gain: Prospective Naturalistic Study of the Effectiveness of a Supervised Exercise Programme." The Australian and New Zealand Journal of Psychiatry, vol. 41, no. 12, 2007, pp. 980-9.
Poulin MJ, Chaput JP, Simard V, et al. Management of antipsychotic-induced weight gain: prospective naturalistic study of the effectiveness of a supervised exercise programme. Aust N Z J Psychiatry. 2007;41(12):980-9.
Poulin, M. J., Chaput, J. P., Simard, V., Vincent, P., Bernier, J., Gauthier, Y., Lanctôt, G., Saindon, J., Vincent, A., Gagnon, S., & Tremblay, A. (2007). Management of antipsychotic-induced weight gain: prospective naturalistic study of the effectiveness of a supervised exercise programme. The Australian and New Zealand Journal of Psychiatry, 41(12), 980-9.
Poulin MJ, et al. Management of Antipsychotic-induced Weight Gain: Prospective Naturalistic Study of the Effectiveness of a Supervised Exercise Programme. Aust N Z J Psychiatry. 2007;41(12):980-9. PubMed PMID: 17999270.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of antipsychotic-induced weight gain: prospective naturalistic study of the effectiveness of a supervised exercise programme. AU - Poulin,Marie-Josée, AU - Chaput,Jean-Philippe, AU - Simard,Véronique, AU - Vincent,Pierre, AU - Bernier,Joëlle, AU - Gauthier,Yvan, AU - Lanctôt,Guy, AU - Saindon,Jacynthe, AU - Vincent,Annick, AU - Gagnon,Solange, AU - Tremblay,Angelo, PY - 2007/11/14/pubmed PY - 2008/3/1/medline PY - 2007/11/14/entrez SP - 980 EP - 9 JF - The Australian and New Zealand journal of psychiatry JO - Aust N Z J Psychiatry VL - 41 IS - 12 N2 - OBJECTIVE: To determine the potential effectiveness of a behavioural weight control programme including physical exercise in the prevention of antipsychotic-induced weight gain and associated comorbid conditions in outpatients with schizophrenia and mood disorders. METHODS: A prospective, comparative, open and naturalistic study was carried out for a total of 110 patients with schizophrenia, schizoaffective or bipolar disorders (DSM-IV), on treatment with atypical antipsychotics. Of these, 59 patients participated in an 18 month weight control programme that included an educational activity about dietary and physical activity counselling as well as a structured, supervised, facility-based exercise programme. The control group consisted of 51 patients with the same baseline characteristics who did not receive the clinical programme. Anthropometric measurements, plasma lipid-lipoprotein profile, and fasting plasma glucose concentrations were assessed at 11 time-points over the study. In addition, serum concentrations of prolactin, thyrotropin-stimulating hormone (TSH), and glycated haemoglobin (HbA1c) were assessed at four time-points. Finally, the Clinical Global Impression scale (CGI), the Brief Psychiatric Rating Scale (BPRS) and the Short Form (SF)-36 Health Survey were used. RESULTS: The adherence rate of patients was 85%, both in the active and in the control group. Whereas the control group experienced a significant increase in bodyweight (4.1%), body mass index (BMI; 5.5%) and waist circumference (WC; 4.2%), the active group significantly reduced their bodyweight (-3.5%), BMI (-4.4%), and WC (-4.6%) at the study end-point. In addition, a significant increase in low-density lipoprotein (LDL)-cholesterol (14.8%) and in triglyceride concentrations (12.3%) was observed at month 18 in the control group. In contrast, high-density lipoprotein-cholesterol (HDL) significantly increased (21.4%), and LDL cholesterol (-13.7%), triglycerides (-26.2%), total cholesterol (-12.1%), fasting glucose concentrations (-12.0%), and HbA1c (-11.4%) significantly decreased compared to baseline in the active group. No significant changes were observed regarding serum concentrations of prolactin and TSH during the study. In regard to the changes observed in psychological measures, no between-group differences were seen in the clinical ratings of CGI and BPRS. However, the SF-36 showed that physical health was improved only for subjects in the active group at months 12 and 18 compared to baseline (p<0.05), and mental health was significantly improved for both groups at months 12 and 18 compared to baseline. CONCLUSION: Bodyweight and metabolic risk profile in patients receiving atypical antipsychotic medications can be effectively managed with a weight control programme including physical activity. SN - 0004-8674 UR - https://www.unboundmedicine.com/medline/citation/17999270/Management_of_antipsychotic_induced_weight_gain:_prospective_naturalistic_study_of_the_effectiveness_of_a_supervised_exercise_programme_ L2 - https://journals.sagepub.com/doi/10.1080/00048670701689428?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -