Predictorsand correlates for weight changes in patients co-treatedwith olanzapine and weight mitigating agents; a post-hoc analysis
This study focuses on exploring the relationship between changes in appetite or eating behaviors and subsequent weight change for adult patients with schizophrenia or bipolar disorder treated with olanzapine and adjunctive potential weight mitigating pharmacotherapy. The aim is not to compare different weight mitigating agents, but to evaluate patients' characteristics and changes in their eating behaviors during treatment.
Identification of patient subgroups with different degrees of susceptibility to the effect of weight mitigating agents during olanzapine treatment may aid clinicians in treatment decisions.
Methods: Data were obtained from 3 randomized, double-blind, placebo-controlled, 16-week clinical trials.
Included were 158 patients with schizophrenia or bipolar disorder and a body mass index (BMI) [greater than or equal to]25 kg/m2 who had received olanzapine treatment in combination with nizatidine (n=68), sibutramine (n=42), or amantadine (n=48). Individual patients were analyzed for categorical weight loss [greater than or equal to]2 kg and weight gain [greater than or equal to]1 kg.
Variables that were evaluated as potential predictors of weight outcomes included baseline patient characteristics, factors of the Eating Inventory, individual items of the Eating Behavior Assessment, and the Visual Analog Scale.
Results: Predictors/correlates of weight loss [greater than or equal to]2 kg included: high baseline BMI, low baseline interest in food, and a decrease from baseline to endpoint in appetite, hunger, or cravings for carbohydrates. Reduced cognitive restraint, increase in hunger, and increased overeating were associated with a higher probability of weight gain [greater than or equal to]1 kg.
Conclusions: The association between weight gain and lack of cognitive restraint in the presence of increased appetite suggests potential benefit of psychoeducational counseling in conjunction with adjunctive pharmacotherapeutic agents in limiting weight gain during antipsychotic drug therapy.Trial Registration: This analysis was not a clinical trial and did not involve any medical intervention.
Author: Virginia L Stauffer, Ilya Lipkovich, Vicki Poole Hoffmann, Alexandra N Heinloth, H SCOTT McGregor and Bruce J Kinon
Credits/Source: BMC Psychiatry 2009, 9:12
Published on: 2009-03-29
Copyright by the authors listed above - made available via BioMedCentral (Open Access). Please
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