Mental Health service, Fiona Stanley Fremantle Hospitals Group, Murdoch, WA, Australia.
Dept of Psychiatry, University of Cambridge, Cambridge, UK.
Curr Opin Psychiatry. 2024 Sep 1;37(5):331-336. doi: 10.1097/YCO.0000000000000953. Epub 2024 Jun 10.
Psychotropic drug related weight gain is a common side-effect of significant concern to both clinicians and patients. Recent studies and treatment guidelines strongly support taking preventive and early treatment approaches to psychotropic drug-related weight gain (PDWG). Arguably the main pathway that PDWG occurs is via changes in eating behaviour leading to increased caloric intake.
Systematic reviews and meta-analyses have provided good data on the nature and prevalence of alterations in eating behaviour with psychotropic treatment including increased hunger, night eating and binge eating. These changes are unsurprisingly more prominent with agents like olanzapine and clozapine that have high propensity to cause weight gain.
Altered eating behaviour can serve as an earlier measure of the risk of weight gain and can be examined easily in clinical practice. Detecting these changes can enable earlier action in terms of switching treatments and starting pharmacological and nonpharmacological preventive strategies.
精神药物相关的体重增加是一个常见的副作用，引起了临床医生和患者的高度关注。最近的研究和治疗指南强烈支持采取预防和早期治疗精神药物相关体重增加（PDWG）的方法。可以说，PDWG 发生的主要途径是通过改变饮食行为导致热量摄入增加。
系统评价和荟萃分析提供了关于精神药物治疗中饮食行为改变的性质和流行率的良好数据，包括饥饿感增加、夜间进食和暴食。这些变化在像奥氮平和氯氮平这样的药物中更为明显，因为它们有很高的导致体重增加的倾向。
改变的饮食行为可以作为体重增加风险的早期衡量标准，并可以在临床实践中轻松检查。检测这些变化可以促使更早地采取治疗转换、开始药物和非药物预防策略的行动。
