Stanford University School of Medicine, Stanford, CA, USA.
J Psychiatr Res. 2011 Aug;45(8):1128-32. doi: 10.1016/j.jpsychires.2011.01.019. Epub 2011 Mar 2.
To assess effectiveness and tolerability of open adjunctive ziprasidone for weight loss in obese/overweight patients with bipolar disorders (BD) in diverse mood states, taking weight gain-implicated psychotropic medications.
22 obese and three overweight BD patients (20 female; 10 BD-I, 14 BD-II, 1 BD-NOS) with mean ± SD baseline body mass index (BMI) of 31.8 ± 2.5 kg/m2 received ZIP (mean final dose 190 ± 92 mg/day) for mean of 79.2 ± 23.2 days. Weight was assessed at six weekly and three biweekly visits. Subjects entered the study in diverse mood states. At baseline, 21 were taking second-generation antipsychotics, 7 lithium, and 1 valproate, which could be reduced/discontinued at investigators' discretion.
Weight and BMI decreased from baseline to endpoint by 4.5 ± 3.4 kg and 1.6 ± 1.2 kg/m2, respectively, at weekly rates of 0.37 kg and 0.13 kg/m2, respectively (all p < 0.00001). 48% of patients had at least 5% weight loss. Obesity rate decreased from 88% to 35% (p < 0.0001). Waist circumference decreased 1.6 inches (p = 0.0001). Overall, mood did not change. Patients with at least moderate baseline mood symptoms experienced significant mood improvement, despite 72% patients decreasing/discontinuing weight gain-implicated psychotropic medications. Seven patients discontinued ZIP early: 3 for weight loss inefficacy, and 1 each for viral gastroenteritis, loss of consciousness, pneumonia with hypomania, and lost to follow up.
Open adjunctive ziprasidone may be effective for weight loss in obese/overweight BD patients taking weight gain-implicated psychotropic medications. These preliminary data should be considered with caution due to the open uncontrolled design, small sample size, and brief duration.
评估在服用可能导致体重增加的精神药物的不同心境状态下，肥胖/超重的双相障碍（BD）患者使用开放辅助齐拉西酮治疗的有效性和耐受性，以减轻体重。
22 名肥胖和 3 名超重的 BD 患者（20 名女性；10 名 BD-I，14 名 BD-II，1 名 BD-NOS），平均基线身体质量指数（BMI）为 31.8 ± 2.5 kg/m2，接受齐拉西酮（平均最终剂量 190 ± 92 mg/天）治疗，平均治疗时间为 79.2 ± 23.2 天。体重在六次每周和三次双周就诊时进行评估。受试者在不同的心境状态下进入研究。基线时，21 名患者正在服用第二代抗精神病药物，7 名患者服用锂盐，1 名患者服用丙戊酸盐，可根据研究者的判断减少/停用。
体重和 BMI 从基线到终点分别下降了 4.5 ± 3.4 kg 和 1.6 ± 1.2 kg/m2，每周下降 0.37 kg 和 0.13 kg/m2，均为（p < 0.00001）。48%的患者体重减轻至少 5%。肥胖率从 88%下降到 35%（p < 0.0001）。腰围减少了 1.6 英寸（p = 0.0001）。总体而言，情绪没有变化。尽管 72%的患者减少/停用了可能导致体重增加的精神药物，但至少有中度基线情绪症状的患者情绪显著改善。7 名患者提前停用齐拉西酮：3 名因体重减轻无效，1 名因病毒性肠胃炎、意识丧失、肺炎伴轻躁狂和失访而停用。
开放辅助齐拉西酮可能对服用可能导致体重增加的精神药物的肥胖/超重 BD 患者的体重减轻有效。由于开放非对照设计、样本量小和治疗时间短，这些初步数据应谨慎考虑。
