Attenuating effect of reboxetine on appetite and weight gain in olanzapine-treated schizophrenia patients : a double-blind placebo-controlled study

• Published in: Psychopharmacologia Vol. 192; no. 3; pp. 441 - 448
• Main Authors: POYUROVSKY, Michael, FUCHS, Camil, PASHINIAN, Artashez, LEVI, Aya, FARAGIAN, Sarit, MAAYAN, Rachel, GIL-AD, Irit
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01.06.2007; Springer Nature B.V
• Subjects: Adrenergic Uptake Inhibitors - adverse effects; Adrenergic Uptake Inhibitors - pharmacology; Adrenergic Uptake Inhibitors - therapeutic use; Adult; Adult and adolescent clinical studies; Antipsychotic Agents - adverse effects; Antipsychotic Agents - therapeutic use; Antipsychotics; Appetite; Appetite - drug effects; Benzodiazepines - adverse effects; Benzodiazepines - therapeutic use; Biological and medical sciences; Body Mass Index; Body weight; Body weight gain; Body weight loss; Clinical significance; Clinical trials; Double-Blind Method; Double-blind studies; Female; Humans; Hunger; Male; Medical sciences; Mental disorders; Middle Aged; Morpholines - adverse effects; Morpholines - pharmacology; Morpholines - therapeutic use; Neuropharmacology; Norepinephrine; Olanzapine; Patients; Pharmacology; Pharmacology. Drug treatments; Physical growth; Placebos; Psychiatry; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psycholeptics: tranquillizer, neuroleptic; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychopharmacology; Psychoses; Psychotropic drugs; Reboxetine; Schizophrenia; Schizophrenia - drug therapy; Weight; Weight Gain - drug effects; Appetite; Human; Reboxetine; Atypical antipsychotic; Olanzapine; Neuroleptic; Psychotropic; Dopamine antagonist; Serotonin antagonist; Schizophrenia; Serotonine receptor; Catecholamine; Reuptake inhibitor; Weight gain; Thienobenzodiazepine derivatives; Psychosis; D2 Dopamine receptor; Placebo; Neurotransmitter; Double blind study; Antidepressant agent; Norepinephrine; Reboxetine, Weight gain; Second generation antipsychotics
• ISSN: 0033-3158; 1432-2072
• DOI: 10.1007/s00213-007-0731-1

Search for safe and effective strategies to diminish weight gain associated with second generation antipsychotics (SGAs) is imperative. In the present study, we sought to replicate our preliminary findings, which indicated that coadministration of the selective norepinephrine reuptake inhibitor reboxetine attenuates olanzapine-induced weight gain. Fifty-nine patients hospitalized for first-episode DSM-IV schizophrenic disorder participated in this randomized double-blind study. Reboxetine (4 mg/day; 31 patients) or placebo (29 patients) was coadministered with olanzapine (10 mg/day) for 6 weeks. Analysis was by intention-to-treat. Nine patients in each group prematurely discontinued the trial. Olanzapine/reboxetine-treated patients showed a significantly lower increase in body weight (mean = 3.31 kg, SD = 2.73) than their olanzapine/placebo-treated counterparts (mean = 4.91 kg, SD = 2.45). Significantly fewer olanzapine/reboxetine-treated patients gained at least 7% of their initial weight, the cutoff for clinically significant weight gain (6 [19.4%] of 31 patients vs 13 [46.4%] of 28 patients). Seven (22.6%) olanzapine/reboxetine-treated patients compared to only one patient (3.6%) in the olanzapine/placebo group revealed no weight change or even modest weight loss. Appetite increase was significantly lower in the olanzapine/reboxetine than olanzapine/placebo group and was correlated with attenuation of weight gain. Reboxetine addition was safe and well tolerated. The results confirm that coadministration of reboxetine promotes a clinically meaningful attenuation of olanzapine-induced weight gain in schizophrenia patients. If substantiated in long-term studies, along with behavioral management and diet counseling, reboxetine may have a clinical utility in controlling SGA-induced weight gain.