Weight gain due to long term antipsychotic treatment of persistent mental disorders

Abstract

Background: Weight gain is a risk factor for hypertension, diabetes, ischemic heart disease, respiratory illnesses, various forms of cancer, and the metabolic syndrome. Obesity is common among psychiatric patients in general and among schizophrenia patients in particular. Antipsychotic treatment may contribute to obesity by increasing appetite. Weight gain may also be related to apathy regarding body enhancement, reduction of interest, and need for oral gratifications associated with psychiatric disorders.

Methods: We examined weight gain among inpatients who received anti-psychotic drug therapy for one year or longer and compared weight gain in patients treated with first and second generation antipsychotic therapy.

Results: The study group included 70 patients treated with second-generation antipsychotic agents for one year or longer (risperidone N=40; olanzapine N=30). The control group included 30 patients who were treated with first generation antipsychotics. We compared weight prior to initiation of antipsychotic treatment and one year later, and demographic and medical data as recorded in the patients' medical files. Following one year of treatment 55% of the patients increased their weight, 2% remained at the same weight and 43% had lost weight.

Conclusions: Our study showed that there are differences in the direction of weight changes among the patients: while most of the patients gain weight during treatment, some lose weight. Consequently there is no alternative to personal follow up for each individual patient and personal treatment plans for medication, diet and physical exercise.