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Antipsychotic induced weight gain

Tongeji E Tungaraza
It has been repeatedly shown that clozapine is more efficacious than other antipsychotics in the management of treatment-resistant schizophrenia. However, clozapine is associated with a number of side effects including weight gain. Antipsychotic-induced weight gain has been linked with a number of untoward events including psychological factors such as stigma and low self-esteem, and physical factors such as metabolic syndromes and untimely death. The mechanism underlying antipsychotic (including clozapine)-induced weight gain is not clearly understood, although it is said to involve several brain areas, several neurotransmitters, neuropeptides and genetic factors...
October 2016: Therapeutic Advances in Psychopharmacology
Varuni Asanka de Silva, Chathurie Suraweera, Suhashini S Ratnatunga, Madhubashinee Dayabandara, Nimali Wanniarachchi, Raveen Hanwella
BACKGROUND: Most antipsychotics are associated with weight gain and other metabolic complications. Several randomized trials have shown metformin to be effective, but this still hasn't been included in clinical guidelines on managing antipsychotic induced weight gain. METHODS: All double blind placebo controlled trials assessing the efficacy of metformin in the treatment of antipsychotic induced weight gain were included. Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE were searched for the period January 2000-December 2015...
October 3, 2016: BMC Psychiatry
Kamini Vasudev, Yun-Hee Choi, Ross Norman, Richard B Kim, Ute I Schwarz
OBJECTIVE: Atypical antipychotics are linked to a higher incidence of metabolic side effects, including weight gain, dyslipidemia, and diabetes. In this study, we examined the prevalence and potential genetic predictors of metabolic side effects in 60 adult patients on clozapine. METHOD: Genetic variants of relevance to clozapine metabolism, clearance, and response were assessed through targeted genotyping of cytochrome P450 enzymes CYP1A2 and CYP2C19, the efflux transporter ABCB1, the serotonin receptor (HTR2C), leptin (LEP), and leptin receptor (LEPR)...
September 28, 2016: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Jonathan R Scarff
Schizophrenia occurs in approximately 0.3 to 0.7 percent of the world's population and is associated with significant morbidity and mortality. Although atypical antipsychotics reduce positive and negative symptoms, they are associated with varying degrees of metabolic adverse effects. This necessitates continued development of efficacious yet metabolically favorable treatments. This article reviews brexpiprazole, a medication recently approved to treat patients with schizophrenia. Brexpiprazole was well-tolerated, and adverse reactions were statistically insignificant...
July 2016: Innovations in Clinical Neuroscience
Narjes Hendouei, Seyed Hamzeh Hosseini, Amin Panahi, Zahra Khazaeipour, Fatemeh Barari, Adeleh Sahebnasagh, Shahram Ala
Recently, extensive efforts have been made to understand the rate of energy expenditure and the weight gain associated with atypical antipsychotic treatment, including identification of markers of obesity risk. In recent years, leptin, an adipocyte hormone, has gained significant interest in psychiatric disorders. S100B has been considered as a surrogate marker for astrocyte-specific damage in neurologic disorders. Also, S100B has been detected in adipose with concentration as high as nervous tissue as a second release source...
2016: Iranian Journal of Pharmaceutical Research: IJPR
Raymond R MacNeil, Daniel J Müller
The effectiveness of antipsychotic drugs is limited due to accompanying adverse effects which can pose considerable health risks and lead to patient noncompliance. Pharmacogenetics (PGx) offers a means to identify genetic biomarkers that can predict individual susceptibility to antipsychotic-induced adverse effects (AAEs), thereby improving clinical outcomes. We reviewed the literature on the PGx of common AAEs from 2010 to 2015, placing emphasis on findings that have been independently replicated and which have additionally been listed to be of interest by PGx expert panels...
July 2016: Molecular Neuropsychiatry
Trehani M Fonseka, Daniel J Müller, Sidney H Kennedy
Antipsychotic medications (APs), particularly second-generation APs, are associated with significant weight gain in schizophrenia patients. Recent evidence suggests that the immune system may contribute to antipsychotic-induced weight gain (AIWG) via AP-mediated alterations of cytokine levels. Antipsychotics with a high propensity for weight gain, such as clozapine and olanzapine, influence the expression of immune genes, and induce changes in serum cytokine levels to ultimately down-regulate neuroinflammation...
May 2016: Molecular Neuropsychiatry
Virginio Salvi, Claudio Mencacci, Francesco Barone-Adesi
Weight gain and metabolic abnormalities are extensively found in patients taking psychotropic medications. Although mainly antipsychotics have been implicated, also antidepressants carry the potential to induce weight gain, with tricyclics and mirtazapine being associated with the greatest weight gain. It has been suggested that this could be due to the different ability of antidepressants to block adrenergic, cholinergic, and histaminergic postsynaptic receptors. To date, however, the link between antidepressant-induced weight gain and their receptor affinity profile has not been established...
October 2016: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
Evdokia Anagnostou, Michael G Aman, Benjamin L Handen, Kevin B Sanders, Amy Shui, Jill A Hollway, Jessica Brian, L Eugene Arnold, Lucia Capano, Jessica A Hellings, Eric Butter, Deepali Mankad, Rameshwari Tumuluru, Jessica Kettel, Cassandra R Newsom, Stasia Hadjiyannakis, Naomi Peleg, Dina Odrobina, Sarah McAuliffe-Bellin, Pearl Zakroysky, Sarah Marler, Alexis Wagner, Taylor Wong, Eric A Macklin, Jeremy Veenstra-VanderWeele
IMPORTANCE: Atypical antipsychotic medications are indicated for the treatment of irritability and agitation symptoms in children with autism spectrum disorder (ASD). Unfortunately, these medications are associated with weight gain and metabolic complications that are especially troubling in children and with long-term use. OBJECTIVE: To evaluate the efficacy of metformin for weight gain associated with atypical antipsychotic medications in children and adolescents with ASD (defined in the protocol as DSM-IV diagnosis of autistic disorder, Asperger disorder, or pervasive developmental disorder not otherwise specified), aged 6 to 17 years...
September 1, 2016: JAMA Psychiatry
Christopher J McDougle
No abstract text is available yet for this article.
September 1, 2016: JAMA Psychiatry
Constance Mennella, Daniel P Dickstein
No abstract text is available yet for this article.
August 22, 2016: Journal of Child and Adolescent Psychopharmacology
Katerina Horska, Jana Ruda-Kucerova, Zuzana Babinska, Michal Karpisek, Regina Demlova, Radka Opatrilova, Pavel Suchy, Hana Kotolova
OBJECTIVE: Metabolic adverse effects of atypical antipsychotics (AAP) contribute significantly to increased risk of cardiovascular morbidity and mortality in patients suffering from schizophrenia. Extensive preclinical research has addressed this issue over the past years, though mechanisms underlying these adverse effects of AAP are still not understood completely. Recently, attention is drawn towards the role of adipose tissue metabolism and neurohormonal regulations. METHODS: The aim of this study was to evaluate the time-dependent effects of olanzapine depot administration at clinically relevant dosing on the regulation of energy homeostasis, glucose and lipid metabolism, gastrointestinal and adipose tissue-derived hormones involved in energy balance regulations in female Sprague-Dawley rats...
November 2016: Psychoneuroendocrinology
Mahmoud Slim, Inmaculada Medina-Caliz, Andres Gonzalez-Jimenez, M Rosario Cabello, Fermin Mayoral-Cleries, M Isabel Lucena, Raul J Andrade
The newer atypical antipsychotic agents (AAPs) represent an attractive therapeutic option for a wide range of psychotic disorders, including schizophrenia and bipolar mania, because of the reduced risk of disabling extrapyramidal symptoms. However, their growing use has raised questions about their tolerability over the endocrine, metabolic, and cardiovascular axes. Indeed, atypical antipsychotic drugs are associated, to differing extents, with mild elevation of aminotransferases related to weight gain, AAP-induced metabolic syndrome, and nonalcoholic fatty liver disease...
October 2016: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
F M Daray, D Rodante, L G Carosella, M E Silva, M Martínez, M V Fernández Busch, D F Faccone, R P Rothlin, P C Maffía
Introduction: The HTR2C gene is an important candidate in pharmacogenetic studies of antipsychotic-induced weight gain (AIWG). However, inconsistent results have been obtained. The present study investigated the association between -759C>T, functional polymorphism of the HTR2C receptor, and AIWG. Methods: A prospective cohort of 48 female inpatients with schizophrenia and related illness treated according to normal clinical practice with second generation antipsychotics (SGAs) risperidone, clozapine, quetiapine, and olanzapine were evaluated...
July 14, 2016: Pharmacopsychiatry
Jagan R Etukala, Xue Y Zhu, Suresh V K Eyunni, Edem K Onyameh, Edward Ofori, Barbara A Bricker, Hye J Kang, Xi-Ping Huang, Bryan L Roth, Seth Y Ablordeppey
Several known D2 pharmacophores have been explored as templates for identifying ligands with multiple binding affinities at dopamine and serotonin receptors considered as clinically relevant receptors in the treatment of neuropsychiatric diseases. This approach has resulted in the identification of ligands that target multiple CNS receptors while avoiding others associated with deleterious effects. In particular, compounds 11, 15 and 22 may have potential for further development as antipsychotic agents as they favorably interact with the clinically relevant receptors including D2R, 5-HT1AR, and 5-HT7R...
August 15, 2016: Bioorganic & Medicinal Chemistry
L Orsolini, C Tomasetti, A Valchera, R Vecchiotti, I Matarazzo, F Vellante, F Iasevoli, E F Buonaguro, M Fornaro, A L C Fiengo, G Martinotti, M Mazza, G Perna, A Carano, A De Bartolomeis, M Di Giannantonio, D De Berardis
INTRODUCTION: The atypical antipsychotic (APs) drugs have become the most widely used agents to treat a variety of psychoses because of their superiority with regard to safety and tolerability profile compared to conventional/'typical' APs. AREAS COVERED: We aimed at providing a synthesis of most current evidence about the safety and tolerability profile of the most clinically used atypical APs so far marketed. Qualitative synthesis followed an electronic search made inquiring of the following databases: MEDLINE, Embase, PsycINFO and the Cochrane Library from inception until January 2016, combining free terms and MESH headings for the topics of psychiatric disorders and all atypical APs as following: ((safety OR adverse events OR side effects) AND (aripiprazole OR asenapine OR quetiapine OR olanzapine OR risperidone OR paliperidone OR ziprasidone OR lurasidone OR clozapine OR amisulpride OR iloperidone))...
October 2016: Expert Opinion on Drug Safety
Robert T Franke, Emilia Tarland, Heidrun Fink, Heinz H Pertz, Jan Brosda
RATIONALE: Recently, we showed that 2-bromoterguride acted as a dopamine D2 receptor partial agonist, a serotonin 5-HT2A and α2C-adrenergic receptor antagonist, and exhibited antidopaminergic efficacy in amphetamine-induced locomotion (AIL) in rats without inducing catalepsy. OBJECTIVE: To extend our knowledge on the antipsychotic effects of 2-bromoterguride, we used convergent preclinical animal models and tests; i.e., conditioned avoidance response (CAR), predictive of antipsychotic-like effects; Fos protein expression, a molecular marker for (atypical) antipsychotic activity; wet dog shake behavior, a test for the in vivo effects of drugs acting on central 5-HT2A receptors; and investigated metabolic changes as a common side effect of atypical antipsychotic drugs (APDs)...
August 2016: Psychopharmacology
Hee Ryung Wang, Young Sup Woo, Won-Myong Bahk
This systematic review aims to investigate whether melatonin or melatonin agonists significantly attenuate metabolic side effects among psychiatric populations treated with atypical antipsychotics. Four randomized-controlled trials were identified through a comprehensive literature search using MEDLINE, EMBASE, and the Cochrane Library on 22 October 2015. These four trials (including three melatonin studies and one ramelteon study) included 138 patients, of whom 71 were treated with melatonin or ramelteon and 67 were treated with a placebo...
November 2016: International Clinical Psychopharmacology
Donatella Marazziti, Armando Piccinni, Stefano Baroni, Francesco Mungai, Silvio Presta, Federico Mucci, Liliana Dell'Osso
Over the years, both first- (FGAs) and second-generation antipsychotics (SGAs), continue to gain increasing evidence of being effective in the treatment of psychotic symptoms. Currently, they represent the first-line treatment of schizophrenia and bipolar disorder, although they are widely used in psychotic depression and other clinical conditions, such as agitation and/or behavioural disturbances. Despite representing an indispensable tool for the treatment of severe psychotic disorders, they are widely known to have a number of unwanted side effects that the clinician must be aware of, and handle carefully to provide the patient the best available treatment in the short and long-term...
2016: Current Medicinal Chemistry
Jian-Ping Zhang, Todd Lencz, Ryan X Zhang, Masahiro Nitta, Lawrence Maayan, Majnu John, Delbert G Robinson, W Wolfgang Fleischhacker, Rene S Kahn, Roel A Ophoff, John M Kane, Anil K Malhotra, Christoph U Correll
Although weight gain is a serious but variable adverse effect of antipsychotics that has genetic underpinnings, a comprehensive meta-analysis of pharmacogenetics of antipsychotic-related weight gain is missing. In this review, random effects meta-analyses were conducted for dominant and recessive models on associations of specific single nucleotide polymorphisms (SNP) with prospectively assessed antipsychotic-related weight or body mass index (BMI) changes (primary outcome), or categorical increases in weight or BMI (≥7%; secondary outcome)...
November 2016: Schizophrenia Bulletin
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