Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, University Hospital Centre and University of Lausanne, Prilly, Lausanne, Switzerland.
J Psychiatr Res. 2012 Apr;46(4):540-8. doi: 10.1016/j.jpsychires.2012.01.014. Epub 2012 Feb 7.
To describe the weight gain-related side-effects of psychotropic drugs and their consequences on metabolic complications (hypercholesterolemia, obesity) in a Swiss cohort of psychiatric patients.
This cross-sectional observational study was performed in an out-patient psychiatric division with patients having received for more than 3 months the following drugs: clozapine, olanzapine, quetiapine, risperidone, lithium, and/or valproate. Clinical measures and lifestyle information (smoking behaviour, physical activity) were recorded.
196 inclusions were completed. Weight gain (≥10% of initial weight) following drug treatment was reported in 47% of these patients. Prevalence of obesity (BMI ≥ 30), hypercholesterolemia (≥6.2 mmol/L) and low HDL-cholesterol (<1.0 mmol/L in men, <1.3 mmol/L in women) were present in 38%, 21%, and 27% of patients, respectively. A higher standardised dose, an increase of appetite following medication introduction, the type of medication (clozapine or olanzapine > quetiapine or risperidone > lithium or valproate), and the gender were shown to be significantly associated with evolution of BMI.
High prevalence of obesity and hypercholesterolemia was found in an out-patient psychiatric population and confirms drug-induced weight gain complications during long-term treatment. The results support the recently published recommendations of monitoring of metabolic side-effects during treatment with atypical antipsychotics. Moreover, the weight gain predictors found in the present study could help to highlight patients with special health care management requirement.
描述精神科患者在瑞士队列中使用精神药物相关的体重增加副作用及其对代谢并发症（高胆固醇血症、肥胖）的影响。
本横断面观察性研究在一家门诊精神科进行，纳入的患者在过去 3 个月以上接受了以下药物治疗：氯氮平、奥氮平、喹硫平、利培酮、锂和/或丙戊酸钠。记录了临床指标和生活方式信息（吸烟行为、体力活动）。
完成了 196 例纳入。这些患者中有 47%报告了药物治疗后体重增加（≥初始体重的 10%）。肥胖（BMI≥30）、高胆固醇血症（≥6.2mmol/L）和低高密度脂蛋白胆固醇（男性<1.0mmol/L，女性<1.3mmol/L）的患病率分别为 38%、21%和 27%。更高的标准化剂量、药物治疗后食欲增加、药物类型（氯氮平或奥氮平>喹硫平或利培酮>锂或丙戊酸钠）以及性别与 BMI 的变化显著相关。
在门诊精神科人群中发现了肥胖和高胆固醇血症的高患病率，证实了长期治疗中药物引起的体重增加并发症。这些结果支持了最近发表的关于在使用非典型抗精神病药物治疗期间监测代谢副作用的建议。此外，本研究中发现的体重增加预测因素可有助于突出需要特殊医疗保健管理的患者。
