Abstract
ObjectiveAntipsychotic‐induced weight gain (AiWG) is a debilitating adverse effect of most antipsychotics. First‐episode psychosis patients are particularly vulnerable to the detrimental consequences of AiWG. Amisulpride has good efficacy and tolerability. We here aimed to identify the phenotypic factors associated with amisulpride‐induced weight gain in first‐episode psychosis patients.MethodData were collected from the Optimization of Treatment and Management of Schizophrenia in Europe trial. Multivariable regression models with various phenotypic variables (N = 305) were performed with absolute AiWG and clinically relevant AiWG (≥7% AiWG) as outcomes.ResultsFour weeks of amisulpride treatment increased body weight from 69.7 to 72.4 kg (P < 0.001). In the regression model of absolute AiWG, unemployment (β = 0.94, P = 0.016), younger age (β = −0.07, P = 0.031) and absence of current comorbid major depression disorder (β = −1.61, P = 0.034) were positively associated with absolute AiWG. In the regression model of clinically relevant AiWG, unemployment (OR = 2.83, P = 0.001), schizophreniform disorder (OR = 2.00, P = 0.025) and low baseline weight (OR = 0.97, P = 0.032) increased the likelihood of clinically relevant AiWG.ConclusionsClinicians prescribing amisulpride should consider the relatively high susceptibility to AiWG in unemployed first‐episode patients with psychosis, in particular young subjects with a diagnosis of schizophreniform disorder. We advise to carefully monitor these patients and, when needed, implement weight‐reducing strategies.
Highlights
Antipsychotic-induced weight gain (AiWG) is one of the most common side-effects of antipsychotics and is a well-known risk factor for type 2 diabetes mellitus and metabolic syndrome [1]
We identified several variables that may be used in clinical practice to help clinicians monitor amisulpride-induced weight gain more closely
Young age, absence of current comorbid major depressive disorder (MDD), diagnosis of schizophreniform disorder, and lower body weight at baseline as factors positively associated with amisulpride-induced weight gain
Summary
Antipsychotic-induced weight gain (AiWG) is one of the most common side-effects of antipsychotics and is a well-known risk factor for type 2 diabetes mellitus and metabolic syndrome [1]. AiWG carries psychosocial consequences such as lower self-esteem and social isolation which may subsequently trigger treatment non-adherence [3]. These consequences of AiWG negatively influence the effectiveness of antipsychotic therapy but they affect quality of life and mortality in patients using antipsychotics [4]. Several demographic and clinical factors have been associated with AiWG, most importantly young age, female sex, non-white ethnicity, higher antipsychotic dose and lower BMI [6,7,8]
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