University Hospital of Psychiatry, Bern, Switzerland.
Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany.
Acta Psychiatr Scand. 2018 Aug;138(2):110-122. doi: 10.1111/acps.12879. Epub 2018 Mar 30.
A plethora of data deriving from single studies as well as meta-analyses demonstrates that weight gain is associated with the exposure to the majority of antipsychotics (AP). However, potential sex differences have widely evaded the attention of AP treatment trials. It is hypothesised that female patients gain more weight compared with male patients due to their enhanced susceptibility to adverse drug reactions.
A meta-analysis was conducted using clinical trials of AP that reported weight change separately for female and male patients. Duration of AP use was stratified in four categories: <6 weeks, 6-16 weeks, 16-38 weeks and >38 weeks. Forest plots were generated for men and women separately, stratified by AP as well as by duration of use. Sex differences were tested by performing meta-regression.
Data of 26 studies were used in the present analysis because sufficient data were available only for olanzapine, risperidone and the no-medication group. Both female and male patients showed considerable weight gain after switch or initiate of olanzapine or risperidone, but meta-regression analyses did not show significant sex differences.
The present meta-analysis revealed that sex differences in AP-related weight gain have been under investigated hampering the detection of sex-specific patterns. In chronic patients switching to olanzapine or risperidone receiving short-or middle-term treatment, AP were associated with weight gain in both sex subgroups and no significant differences were reported.
大量来自单中心研究和荟萃分析的数据表明，体重增加与大多数抗精神病药物（AP）的暴露有关。然而，潜在的性别差异在抗精神病药物治疗试验中广泛受到忽视。据推测，由于女性对药物不良反应的敏感性增强，与男性患者相比，女性患者体重增加更多。
对分别报告女性和男性患者体重变化的抗精神病药物临床试验进行荟萃分析。抗精神病药物使用时间分为四个类别：<6 周、6-16 周、16-38 周和>38 周。分别为男性和女性生成森林图，按抗精神病药物和使用时间分层。通过进行荟萃回归分析来检验性别差异。
本分析使用了 26 项研究的数据，因为仅奥氮平、利培酮和无药物组有足够的数据。女性和男性患者在换用或起始奥氮平或利培酮后均出现明显的体重增加，但荟萃回归分析并未显示出显著的性别差异。
本荟萃分析显示，抗精神病药物相关体重增加的性别差异研究不足，阻碍了对性别特异性模式的检测。在慢性患者换用奥氮平或利培酮接受短期或中期治疗时，两种性别亚组均与抗精神病药物相关的体重增加相关，且未报告显著差异。
