Atypical antipsychotics and weight gain

crackpotbaby

Wasn't sure which catagory to post this but here is probably ok.

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The Effect of a Calorie-Restricted Diet on Weight Gain in Short-Term Psychiatric Inpatients Receiving Atypical Antipsychotic Medications
Author: Jacobowitz, William; Derbabian, Barbara; Saunders, Anne
ProQuest document link

Abstract:
This study attempted to evaluate the effect of a calorie-restricted diet on weight change in short-term acute care psychiatric patients receiving atypical antipsychotic medication. A descriptive correlational design utilizing chart review and a convenience sample of 100 participants was used. Fifty charts of patients hospitalized prior to the implementation of the calorie-restricted diet for those receiving atypical antipsychotic agents were compared to 50 charts of patients who received the diet. Weight changes in the two groups were compared relative to age, gender, length of time taking the medication, and the type of medication. The Mann-Whitney U test, Spearman's rank-correlation coefficient, and the two-way analysis of variance were used to conduct the analyses. The calorie-restricted diet was not significantly associated with a reduction in weight gain in participants who received any of the atypical antipsychotic agents except for olanzapine; therefore, findings indicate that the calorie-restricted diet may only be effective for patients receiving olanzapine. [Journal of Psychosocial Nursing and Mental Health Services, 52(7), 30-37.]

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You may find it hard to access the full text unless you have access to a university or hospital database. There a few design flaws in this study, not so much 'evidence' as interesting finding - however, they look at caloric restriction (2000cal/day) in regard to weight gain management in patients taking atypical antipsychotics.

The most interesting finding to me personally was that weight loss from calorie restriction alone only was demonstated in a couple of specific drugs, not all.

It was a small sample size though with baseline variables, but for anyone like my myself who rapidly gained >20% of my starting body weight while running through a string of this class of drugs this paper (or at least abstract) may be of interest.

singingflutelady

I was actually part of a clinical trial using olanzapine for anorexia weight restoration. It didn't change my weight gain rate (0.5 kg a week usually) but I fought it like crazy (I was for sure on the real thing). It made me lazier and more apathetic until my body got used to it.

http://www.medscape.com/viewarticle/577666

singingflutelady

Actual study http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2008.07121900?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed#/doi/abs/10.1176/appi.ajp.2008.07121900?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed

crackpotbaby

singingflutelady wrote: »

I was actually part of a clinical trial using olanzapine for anorexia weight restoration. It didn't change my weight gain rate (0.5 kg a week usually) but I fought it like crazy (I was for sure on the real thing). It made me lazier and more apathetic until my body got used to it.

http://www.medscape.com/viewarticle/577666

That's interesting. I wonder if perhaps the brain chemistry of a person taking a drug impacts the metabolic side effects. The brain of an anorexic patient would differ from that of an acutely unwell schizophrenic or bipolar patient.

Although, I've known of anorexic patients to feed their nasogastric tubes so the food runs into the mattress, or run on their beds with on 'bed rest' to the point they had heart attacks so I can imagine the extent 'fighting like crazy' might look like against weight gain. That said, in most studies participants don't know if they are taking an intervention or placebo as it can skew data considerably.

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In the study I've posted about, olanzapine was the main drug that showed weight loss with the calorie restriction.

With other atypical antipsychotics such as risperidone, quietapine, aripiprazole etc calorie restriction didn't reduce the rate of weight gain.

crackpotbaby

singingflutelady wrote: »

Actual study http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2008.07121900?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed#/doi/abs/10.1176/appi.ajp.2008.07121900?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed

'Results: Compared with placebo, olanzapine resulted in a greater rate of increase in weight, earlier achievement of target body mass index, and a greater rate of decrease in obsessive symptoms. No differences in adverse effects were observed between the two treatment conditions. Conclusions: These preliminary results suggest that olanzapine may be safely used in achieving more rapid weight gain and improvement in obsessive symptoms among women with anorexia nervosa. Replication, in the form of a large multicenter trial, is recommended.'

Further comment though, even if you personally didn't notice any increase in weight gain, the actual study you refer to DID find this to be the case as reported above. That suggests if you were in the actual olanzapine group your results were not in line with the majority of this group.

ddeliciosa

Hmm! Interesting stuff. I'm in my 2nd of year of pharmacy school, but I have yet to go over neuro stuff (that's next year). I was unable to open the full article, but I'm wondering if the participants had any excluding factors for comorbidities (other conditions like diabetes, chronic kidney disease, etc). Or did the study accept everyone? I think that could've skew the data a little, but it definitely warrants further research

singingflutelady

lizery wrote: »

singingflutelady wrote: »

Actual study http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2008.07121900?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed#/doi/abs/10.1176/appi.ajp.2008.07121900?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed

'Results: Compared with placebo, olanzapine resulted in a greater rate of increase in weight, earlier achievement of target body mass index, and a greater rate of decrease in obsessive symptoms. No differences in adverse effects were observed between the two treatment conditions. Conclusions: These preliminary results suggest that olanzapine may be safely used in achieving more rapid weight gain and improvement in obsessive symptoms among women with anorexia nervosa. Replication, in the form of a large multicenter trial, is recommended.'

Further comment though, even if you personally didn't notice any increase in weight gain, the actual study you refer to DID find this to be the case as reported above. That suggests if you were in the actual olanzapine group your results were not in line with the majority of this group.

Yes I'm aware I was the odd one out. I'm actually not 100% sure my info was counted as I was kicked out of the program 1 week after the study finished so who knows.

Oh btw I have a bipolar diagnosis but type 2 with hypomanic (not mania) and have never had any psychotic episodes. I was diagnosed after the study though as that would have excluded me. I only had depression/anxiety diagnoses (and an b/p) but that psychiatrist often commented that I was too happy to be depressed (I was on antidepressants only before the study-had to stop them for the study- but he never figured out that the "happiness" as he called it was hypomania caused by the drugs!)

findingone

I was on Olanzapine (Zyprexa) from 2005 to 2014. It effects your metabolic rate and causes you to be hungry....A LOT. I went from roughly 215 pounds to 335. That med made me so hungry so often that I would literally pig out every single day. Just constantly hungry. And not to mention how many other bad side effects from Olanzapine. I will never take that drug again in my life. I got off the med and started on prolixin. Which is waay more weight neutral and went from 296 to 188 pounds and have been steady for a good time. It's effectiveness in doing what it needs to do for your mental disorder, IMO is very good. It works and helped with my mental state but caused other issues. I had to get off it.

Hell if the FBI had it's way with Carmen Ortiz, being mentally ill would be a crime in itself. What's that? You're bi-polar? Off with his head!

Say no to Olanzapine.

Macy9336

I think the anti psychotics do cause weight gain. I was at 103lbs...shot up to 143lbs. Fighting it tooth and nail and down to 128lbs. Started this MyFitnessPal to see if my diet was part of problem...but no...I average below 1000 calories a day! And yet my bmi is borderline overweight. I really want to get to 115 or so because that is middle of healthy range. But nothing I do seems to work...