OBJECTIVE: The weight gain-related side-effects of psychotropic drugs and their consequences on metabolic complications (hypercholesterolemia, obesity) in a large Swiss cohort of psychiatric patients (n=561) were studied. Pharmacogenetic factors influencing these side-effects were also analyzed.
METHODS: A cross-sectional observational study (n=188) was performed in an out-patient psychiatric division with patients having received for more than one year the following drugs : clozapine, olanzapine, quetiapine, risperidone, lithium, amisulpride, aripiprazole and/or valproate. Another longitudinal study consisted of a follow up of patients being prescribed the same drugs for up to one year (n=373).
RESULTS: For the cross-sectional study, the mean age was 41 years (range : 18–69). Weight gain (>=10 % of initial weight) following drug treatment was reported in 43 % of these patients. A high prevalence of overweight (BMI : 25–30) or obesity (BMI>30) was found in this cohort (63%). For the longitudinal study, the mean age was 48 years (range : 12–96). An increase in the overweight or obesity prevalence was found during treatment in adults (33 %, 35 %, 46 % and 57 %, before, after one, 3 and 12 months of treatment, respectively) and in children (21 %, 29 %, 31 % and 50%, respectively).
CONCLUSION: In conclusion, high prevalence of overweight or obesity was found in an out-patient psychiatric population and confirms drug-induced weight gain complications during long-term treatment. Results on other clinical factors of the metabolic syndrome as well as on analyses of genetic factors linked to obesity and metabolic syndrome will also be shown. This study supports the recently published recommendations of monitoring of metabolic side effects during treatment with atypical antipsychotics and/or mood stabilizers. Moreover, the clinical and genetic weight gain predictors found in the present study could help to highlight patients with special health care management requirements.
