Weight gain induced by haloperidol, risperidone and olanzapine after 1 year: Findings of a randomized clinical trial in a drug-naïve population

• Published in: Schizophrenia research Vol. 99; no. 1; pp. 13 - 22
• Main Authors: Perez-Iglesias, Rocio, Crespo-Facorro, Benedicto, Martinez-Garcia, Obdulia, Ramirez-Bonilla, Maria L., Alvarez-Jimenez, Mario, Pelayo-Teran, Jose M., Garcia-Unzueta, Maria T., Amado, Jose A., Vazquez-Barquero, Jose L.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01.02.2008; Elsevier Science
• Subjects: Adolescent; Adult; Antipsychotic Agents - adverse effects; Antipsychotic Agents - therapeutic use; Antipsychotics; Benzodiazepines - adverse effects; Benzodiazepines - therapeutic use; Biological and medical sciences; Body Mass Index; Chronic Disease; Cohort Studies; Dose-Response Relationship, Drug; Female; First episode psychosis; Follow-Up Studies; Haloperidol; Haloperidol - adverse effects; Haloperidol - therapeutic use; Humans; Long-term; Long-Term Care; Male; Medical sciences; Middle Aged; Neuropharmacology; Olanzapine; Pharmacology. Drug treatments; Psychiatric/Mental Health; Psycholeptics: tranquillizer, neuroleptic; Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; Risperidone; Risperidone - adverse effects; Risperidone - therapeutic use; Spain; Treatment Outcome; Weight gain; Weight Gain - drug effects; First episode psychosis; Antipsychotics; Olanzapine; Long-term; Haloperidol; Risperidone; Weight gain; Human; Atypical antipsychotic; Psychotropic; Neuroleptic; Dopamine antagonist; Serotonin antagonist; Pharmacotherapy; Controlled therapeutic trial; Butyrophenone derivatives; Serotonine receptor; Long term; Thienobenzodiazepine derivatives; Psychosis; D2 Dopamine receptor; Treatment; First episode; Benzisoxazole derivatives
• ISSN: 0920-9964
• DOI: 10.1016/j.schres.2007.10.022

There is little information about weight gain induced by antipsychotics at long-term. To quantify the weight gain induced by first (haloperidol) and second generation antipsychotics (olanzapine and risperidone) in a cohort of drug-naïve subjects after 1 year of treatment. This is a prospective, randomized clinical trial, including a representative sample of first episode psychotic incident cases from a population area of 555.000 people. The main outcome measures were changes in body weight and body mass index at 3 months and at 12 months. Both a per protocol analysis and an intention to treat analysis were conducted. A total of 164 drug-naïve patients were included. At 12 months 144 patients were evaluated. Of them, 66% completed the protocol and 34% needed treatment switch. We found statistically significant differences in weight gain at 3 months: 3.8 kg (± 4.1) for haloperidol, 5.9 kg (± 5.1) for risperidone and 8.4 kg (± 5.0) for olanzapine ( F = 7.045; p = 0.002). After 1 year the difference in weight gain had disappeared: 9.7 kg (± 5.7) for haloperidol, 8.9 kg (± 8.8) for risperidone and 10.9 kg (± 7.2) for olanzapine ( F = 0.817; p = 0.445). Drug-naïve patients experience an extraordinary weight gain after 1 year of treatment with haloperidol, olanzapine or risperidone. The main difference among these treatments is the pattern of weight gain but not the final amount of weight gain.