Assistance Publique-Hôpitaux de Paris, Department of Psychiatry, Corentin-Celton Hospital, Issy-les-Moulineaux, France.
J Clin Psychopharmacol. 2012 Oct;32(5):672-7. doi: 10.1097/JCP.0b013e31826866db.
Although weight gain is one of the most widely studied adverse effects of second-generation antipsychotics, only relatively few studies have specifically evaluated the long-term effect of switching antipsychotic medication on body weight. We aimed to evaluate the impact of switching antipsychotics on body mass index (BMI) during a 6-month follow-up period in a large cohort of patients with schizophrenia.
Data came from a 6-month prospective naturalistic survey in 6007 patients with schizophrenia.
We prospectively studied the effect on BMI of initiating or switching antipsychotic medication after 6 months of treatment among 3801 patients with schizophrenia in a real-life setting. Patients who were being treated with clozapine or olanzapine at baseline were more likely to experience a decrease in BMI during the follow-up period than the patients who were being treated with a conventional antipsychotic (odds ratio, 2.25 and 1.68, respectively). Patients treated with aripiprazole and, to a lesser extent, those treated with risperidone were more likely to experience a decrease in BMI during follow-up than patients treated with conventional antipsychotics (odds ratio, 2.96 and 2.06, respectively).
Our findings suggest that switching antipsychotics could be an effective strategy for reducing or preventing weight gain.
尽管体重增加是第二代抗精神病药物最广泛研究的不良反应之一，但只有相对较少的研究专门评估了转换抗精神病药物对体重的长期影响。我们旨在评估在 6 个月的随访期间，在一大群精神分裂症患者中，转换抗精神病药物对体重指数（BMI）的影响。
数据来自 6007 例精神分裂症患者 6 个月的前瞻性自然主义调查。
我们前瞻性地研究了在基线时接受氯氮平或奥氮平治疗的患者与接受传统抗精神病药物治疗的患者在 6 个月的治疗后开始或转换抗精神病药物治疗对 BMI 的影响。与接受传统抗精神病药物治疗的患者相比，在随访期间接受阿立哌唑治疗的患者（比值比分别为 2.25 和 1.68）更有可能出现 BMI 下降。接受利培酮治疗的患者（比值比为 2.06），其 BMI 下降的可能性略低于接受传统抗精神病药物治疗的患者。
我们的研究结果表明，转换抗精神病药物可能是减少或预防体重增加的有效策略。
