Huang Jing, Hei Gang-Rui, Yang Ye, Liu Chen-Chen, Xiao Jing-Mei, Long Yu-Jun, Peng Xing-Jie, Yang Yi, Zhao Jing-Ping, Wu Ren-Rong
Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China.
China National Clinical Research Center on Mental Disorders, Changsha, China.
Front Pharmacol. 2020 May 22;11:739. doi: 10.3389/fphar.2020.00739. eCollection 2020.
Weight gain and metabolic disturbances, potentially influenced by increased appetite, are common effects of olanzapine treatment in patients with schizophrenia. In this study, we explored the association between olanzapine-induced weight gain and metabolic effects with increased appetite. Drug-naïve, first-episode schizophrenia patients were treated with olanzapine for 12 weeks. Assessments included time to increased appetite, body weight, body mass index, biochemical indicators of blood glucose and lipids, proportion of patients who gained more than 7% or 10% of their baseline weight upon treatment conclusion, patients who developed dyslipidemia, and Positive and Negative Syndrome Scale scores. In total, 33 patients with schizophrenia receiving olanzapine were enrolled and 31 completed the study. During the 12-week olanzapine treatment, 77.4% (24/31) patients had increased appetite with 58.1% (18/31) patients having increased appetite within the first 4 weeks. The mean time for increased appetite was 20.3 days. More patients in the increased appetite group increased their initial body weight by more than 7% after 12 weeks when compared to patients with unchanged appetite (22/24 [91.7%] vs. 3/7 [42.9%], p = 0.004). Earlier increased appetite led to more weight gain during the following month. Overall, 50% of patients in the increased appetite group had dyslipidemia after 12 weeks. Our results demonstrated that olanzapine induced significantly appetite increase in first-episode patients with schizophrenia and appetite increase played a key role in olanzapine-induced weight gain and dyslipidemia.
NCT03451734. Registered March 2, 2018 (retrospectively registered).
体重增加和代谢紊乱是精神分裂症患者使用奥氮平治疗的常见副作用，可能受到食欲增加的影响。在本研究中，我们探讨了奥氮平引起的体重增加及代谢效应与食欲增加之间的关联。首次发作、未使用过药物的精神分裂症患者接受奥氮平治疗12周。评估内容包括食欲增加的时间、体重、体重指数、血糖和血脂的生化指标、治疗结束时体重较基线体重增加超过7%或10%的患者比例、出现血脂异常的患者以及阳性和阴性症状量表评分。共有33例接受奥氮平治疗的精神分裂症患者入组，31例完成研究。在12周的奥氮平治疗期间，77.4%（24/31）的患者食欲增加，其中58.1%（18/31）的患者在最初4周内食欲增加。食欲增加的平均时间为20.3天。与食欲未改变的患者相比，食欲增加组中更多患者在12周后初始体重增加超过7%（22/24 [91.7%] 对3/7 [42.9%]，p = 0.004）。较早出现的食欲增加导致接下来一个月体重增加更多。总体而言，食欲增加组中50%的患者在12周后出现血脂异常。我们的结果表明，奥氮平可使首次发作的精神分裂症患者食欲显著增加，且食欲增加在奥氮平引起的体重增加和血脂异常中起关键作用。
NCT03451734。于2018年3月2日注册（追溯注册）。
