Biedermann Falko, Fleischhacker W Wolfgang, Kemmler Georg, Ebenbichler Christoph F, Lechleitner Monika, Hofer Alex
aDepartment of Psychiatry and Psychotherapy, Biological Psychiatry Division bDepartment of Internal Medicine I, Medical University Innsbruck, Innsbruck cDepartment of Internal and Geriatric Medicine, Hochzirl Hospital, Zirl, Austria.
Int Clin Psychopharmacol. 2014 May;29(3):181-4. doi: 10.1097/YIC.0000000000000022.
Weight gain represents a frequent side effect of antipsychotic drug treatment. The current trial investigated the effect of add-on treatment with sibutramine in schizophrenia outpatients who had gained more than 7% of weight during the course of treatment. This 24-week placebo-controlled study evaluated the effects of sibutramine added to ongoing antipsychotic treatment. Weight, waist-hip ratio, BMI, blood pressure/pulse and ECG were monitored regularly. In addition, several laboratory tests were performed. Psychopathological symptoms and side effects were assessed frequently. Fifteen patients were assigned randomly to add-on treatment with sibutramine 10 mg or placebo. The two groups did not differ in weight, sociodemographic, or clinical data. Eleven patients were considered for statistical analysis. Significant weight loss was observed in the sibutramine group (mean = -6.1 kg), whereas patients on placebo experienced a mean weight gain of 1.9 kg. A reduction in HbA1c was apparent in the sibutramine but not in the placebo group. No significant between-group differences were found in changes in psychopathology or drug safety. This pilot trial suggests that adjunctive treatment with sibutramine may be safe and effective in schizophrenic patients with antipsychotic-induced weight gain.
体重增加是抗精神病药物治疗常见的副作用。当前试验研究了在治疗过程中体重增加超过7%的精神分裂症门诊患者中，添加西布曲明治疗的效果。这项为期24周的安慰剂对照研究评估了在正在进行的抗精神病治疗基础上添加西布曲明的效果。定期监测体重、腰臀比、体重指数、血压/脉搏和心电图。此外，还进行了多项实验室检查。频繁评估精神病理症状和副作用。15名患者被随机分配接受10毫克西布曲明或安慰剂的添加治疗。两组在体重、社会人口统计学或临床数据方面无差异。11名患者纳入统计分析。西布曲明组观察到显著体重减轻（平均=-6.1千克），而服用安慰剂的患者体重平均增加1.9千克。西布曲明组糖化血红蛋白明显降低，而安慰剂组未出现此情况。在精神病理学变化或药物安全性方面，未发现组间有显著差异。这项初步试验表明，对于因抗精神病药物导致体重增加的精神分裂症患者，添加西布曲明治疗可能是安全有效的。
