scholarly journals Weight Gain and Treatment Interruptions with Second-Generation Oral Antipsychotics: Analysis of Patients with Schizophrenia or Bipolar I Disorder

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 160-160
Author(s):  
Michael J. Doane ◽  
Leona Bessonova ◽  
Kathleen Mortimer ◽  
Harry Cheng ◽  
Gregory Donadio ◽  
...  
Keyword(s):  
Weight Gain ◽  
Median Time ◽  
Second Generation ◽  
High Weight ◽  
Bipolar I Disorder ◽  
Treatment Interruptions ◽  
High Weight Gain ◽  
Baseline Weight ◽  
Long Acting

AbstractAmong patients with schizophrenia (SZ) and bipolar I disorder (BD-I) treated with second-generation antipsychotics (SGAs), clinically-significant weight gain (CSWG) and treatment interruptions (TIs) are challenges that may result in morbidity/mortality.CSWG and TIs were assessed among patients who initiated oral SGAs of moderate-to-high weight gain risk (no exposure to index SGAs/first-generation antipsychotics for =12 months) using medical records/claims (OM1 Data Cloud; January 2013-February 2020). Outcomes included CSWG (=7% increase in baseline weight) and TIs (switches [to SGAs of low weight gain risk/long-acting injectables] or discontinuations [no SGAs for >30 days]). Descriptive analyses included proportions of patients with CSWG and TIs, and median time to these outcomes.Approximately three-quarters of patients were overweight/obese at baseline (SZ: N=8,174; BD-I: N=9,142). Within 3 months of SGA initiation, 12% of all patients experienced CSWG. For patients on treatment with index SGAs for >6 months (SZ: 29%; BD-I: 27%), 28% (SZ) and 30% (BD-I) experienced CSWG during follow-up. Median time to CSWG was 14 weeks. CSWG results were numerically similar among patients with SZ and BD-I.Over 96% of patients had TIs during follow-up (median time of 12 [SZ] and 13 [BD-I] weeks). Among patients with CSWG and subsequent TIs and weight measurements, 74% did not return to baseline weight after interrupting treatment; the remainder returned to baseline weight with median times of 38 (SZ) and 39 (BD-I) weeks. Results suggest that most patients with CSWG do not return to baseline weight after stopping treatment with oral SGAs of moderate-to-high weight gain risk.Funding. Alkermes, Inc.

scholarly journals Body mass index and weight change are associated with adult lung function trajectories: the prospective ECRHS study

Thorax ◽  
2020 ◽  
Vol 75 (4) ◽  
pp. 313-320 ◽  
Author(s):  
Gabriela P Peralta ◽  
Alessandro Marcon ◽  
Anne-Elie Carsin ◽  
Michael J Abramson ◽  
Simone Accordini ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Gain ◽  
Lung Function ◽  
Body Mass ◽  
Weight Change ◽  
High Weight ◽  
Overweight And Obesity ◽  
Lung Function Decline ◽  
High Weight Gain

BackgroundPrevious studies have reported an association between weight increase and excess lung function decline in young adults followed for short periods. We aimed to estimate lung function trajectories during adulthood from 20-year weight change profiles using data from the population-based European Community Respiratory Health Survey (ECRHS).MethodsWe included 3673 participants recruited at age 20–44 years with repeated measurements of weight and lung function (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1)) in three study waves (1991–93, 1999–2003, 2010–14) until they were 39–67 years of age. We classified subjects into weight change profiles according to baseline body mass index (BMI) categories and weight change over 20 years. We estimated trajectories of lung function over time as a function of weight change profiles using population-averaged generalised estimating equations.ResultsIn individuals with normal BMI, overweight and obesity at baseline, moderate (0.25–1 kg/year) and high weight gain (>1 kg/year) during follow-up were associated with accelerated FVC and FEV1 declines. Compared with participants with baseline normal BMI and stable weight (±0.25 kg/year), obese individuals with high weight gain during follow-up had −1011 mL (95% CI −1.259 to −763) lower estimated FVC at 65 years despite similar estimated FVC levels at 25 years. Obese individuals at baseline who lost weight (<−0.25 kg/year) exhibited an attenuation of FVC and FEV1 declines. We found no association between weight change profiles and FEV1/FVC decline.ConclusionModerate and high weight gain over 20 years was associated with accelerated lung function decline, while weight loss was related to its attenuation. Control of weight gain is important for maintaining good lung function in adult life.

scholarly journals Differences in the Effectiveness of Long-Acting Injection and Orally Administered Antipsychotics in Reducing Rehospitalization among Patients with Schizophrenia Receiving Home Care Services

2019 ◽  
Vol 8 (6) ◽  
pp. 823
Author(s):  
Hsiao-Fen Hsu ◽  
Chia-Chan Kao ◽  
Ti Lu ◽  
Jeremy C. Ying ◽  
Sheng-Yu Lee
Keyword(s):  
Treatment Group ◽  
Home Care ◽  
Second Generation ◽  
Home Care Services ◽  
Rehospitalization Rate ◽  
Treatment Groups ◽  
Psychiatric Rehospitalization ◽  
Care Services ◽  
Long Acting

The current study explored the differences in the effectiveness of first and second generation long-acting injections and orally administered antipsychotics in reducing the rehospitalization rate among patients with schizophrenia receiving home care services in a medical center in Southern Taiwan. Longitudinal data between 1 January 2006, and 31 December 2015, were collected retrospectively. Patients were classified into three treatment groups: First generation antipsychotic (FGA) long-acting injection (LAI), second generation antipsychotic long-acting injection (SGA) (LAI), and oral antipsychotics. The primary outcomes were the rehospitalization rate and the follow-up time (duration of receiving home care services) until psychiatric rehospitalization. A total of 78 patients with schizophrenia were recruited. The average observation time was about 40 months. The oral treatment group tended to be older with a higher number of female patients and a lower level of education. The FGA treatment group tended to have a higher frequency and duration of hospitalization before receiving home care services. We found no significant differences in the follow-up time or psychiatric rehospitalization rate after receiving home care services among the three treatment groups. We propose that oral and LAI antipsychotics were equally effective when patients received home care services. Our results can serve as a reference for the choice of treatment for patients with schizophrenia in a home care program.

The Study of Breast Milk IGF-1, Leptin, Ghrelin and Adiponectin Levels as Possible Reasons of High Weight Gain in Breast-Fed Infants

2014 ◽  
Vol 65 (4) ◽  
pp. 317-323 ◽  
Author(s):  
Igor Ya Kon ◽  
Natalia M. Shilina ◽  
Maria V. Gmoshinskaya ◽  
Tatiana A. Ivanushkina
Keyword(s):  
Weight Gain ◽  
Breast Milk ◽  
High Weight ◽  
High Weight Gain ◽  
Breast Fed

scholarly journals Coat colour in mouse populations selected for weight gain: support for hitchhiking, not pleiotropy

2013 ◽  
Vol 95 (1) ◽  
pp. 4-13 ◽  
Author(s):  
PHILIP W. HEDRICK
Keyword(s):  
Weight Gain ◽  
Allele Frequency ◽  
High Weight ◽  
Coat Colour ◽  
Correlated Response ◽  
Term Selection ◽  
Low Weight ◽  
High Weight Gain ◽  
Frequency Changes ◽  
Positive Correlations

SummaryWith many molecular markers in many species, research efforts in quantitative genetics have focused on dissecting these traits and understanding the importance of factors such as correlated response due to hitchhiking or pleiotropy. Here, in an examination of long-term selection experiments in mice, the evidence strongly supports the primary importance of hitchhiking on the coat colour loci brown and dilute in mice selected for high weight gain. First, the amount of observed change in coat colour allele frequency could not be explained by genetic drift alone, implying that selection was of high importance. Second, the allele frequency changes included reversals in the direction change, but there were still positive correlations in the early generations with differences in weight gain between the phenotypes. Third, the correlation between the change in allele frequencies and phenotypic difference in weight gain declined over time, consistent with the decay expected from linkage associations. Fourth, the changes at both loci in a short-term selection experiment for low weight gain were in the opposite direction than the changes in the contemporaneous related population selected for high weight gain.

scholarly journals Weight change over two years in people prescribed olanzapine, quetiapine and risperidone in UK primary care: Cohort study in THIN, a UK primary care database

2018 ◽  
Vol 32 (10) ◽  
pp. 1098-1103 ◽  
Author(s):  
David PJ Osborn ◽  
Irene Petersen ◽  
Nick Beckley ◽  
Kate Walters ◽  
Irwin Nazareth ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Weight Gain ◽  
Confidence Interval ◽  
Weight Change ◽  
Antipsychotic Treatment ◽  
Weight Changes ◽  
Baseline Weight ◽  
Care Database

Background: Follow-up studies of weight gain related to antipsychotic treatment beyond a year are limited in number. We compared weight change in the three most commonly prescribed antipsychotics in a representative UK General Practice database. Method: We conducted a cohort study in United Kingdom primary care records of people newly prescribed olanzapine, quetiapine or risperidone. The primary outcome was weight in each six month period for two years after treatment initiation. Weight changes were compared using linear regression, adjusted for age, baseline weight and diagnosis. Results: N = 6338 people received olanzapine, 12,984 quetiapine and 6556 risperidone. Baseline weight was lowest for men treated with olanzapine (80.8 kg versus 83.5 kg quetiapine, 82.0 kg risperidone) and women treated with olanzapine (67.7 kg versus 71.5 kg quetiapine 68.4 kg risperidone. Weight gain occurred during treatment with all three drugs. Compared with risperidone mean weight gain was higher with olanzapine (adjusted co-efficient +1.24 kg (95% confidence interval: 0.69–1.79 kg per six months) for men and +0.77 kg (95% confidence interval: 0.29–1.24 kg) for women). Weight gain with quetiapine was lower in unadjusted models compared with risperidone, but this difference was not significant after adjustment. Conclusion: Olanzapine is more commonly prescribed to people with lower weight. However, after accounting for baseline weight, age, sex and diagnosis, olanzapine is still associated with greater weight gain over two years than risperidone or quetiapine. Baseline weight does not ameliorate the risks of weight gain associated with antipsychotic medication. Weight gain should be assertively discussed and managed for people prescribed antipsychotics, especially olanzapine.

Very High Weight Gain During Exclusive Breastfeeding Followed by Slowdown During Complementary Feeding: Two Case Reports

2018 ◽  
Vol 35 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Melanie Wange Larsson ◽  
Anni Larnkjær ◽  
Sophie Hilario Christensen ◽  
Christian Mølgaard ◽  
Kim F. Michaelsen
Keyword(s):  
Weight Gain ◽  
Exclusive Breastfeeding ◽  
Complementary Feeding ◽  
High Weight ◽  
Case Reports ◽  
High Weight Gain ◽  
Very High

Randomized pilot study of a weight gain prevention intervention for breast cancer patients receiving neoadjuvant chemotherapy.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11090-e11090
Author(s):  
Karen Basen-Engquist ◽  
James L. Murray ◽  
George Baum ◽  
Angelica M. Gutierrez-Barrera ◽  
Banu Arun
Keyword(s):  
Breast Cancer ◽  
Weight Gain ◽  
Cancer Patients ◽  
Weight Gain Prevention ◽  
Breast Cancer Patients ◽  
Prevention Intervention ◽  
Igf I ◽  
Baseline Weight ◽  
Igfbp 3

e11090 Background: Weight gain is a common problem after breast cancer diagnosis and treatment, particularly for women who receive chemotherapy. The weight gain has negative effects on quality of life, increases risk for chronic disease, and may increase risk of breast cancer recurrence. This pilot study tested a behavioral weight gain prevention intervention on weight, IGF-I, and IGFBP-3. Methods: Thirty-nine breast cancer patients receiving neoadjuvant chemotherapy were randomized to the weight gain prevention intervention or usual care. The intervention focused on exercise (resistance training, aerobic) and eating a low energy dense diet. Participants received 20 sessions during chemotherapy (14 in person and 6 by telephone) and 9 sessions after surgery (3 in person, 6 by telephone). They completed weight and other assessments at baseline (t0), mid-chemotherapy (T1), post-chemotherapy (t2), post surgical recovery (T3), after the post-surgical intervention (T4) and long term follow-up 6-9 months post surgery (T5). Serum was collected at T0, T2, T3, and T5 and analyzed for IGF-I and IGFBP-3. Results: Controlling for baseline weight, the intervention group weighed less than the control group at T1-T4, a result which approached significance (p=.08) in the intent to treat analysis. There was also a significant obesity x treatment group interaction, indicating that the intervention was most effective for patients who were obese at baseline (p=0.03). The groups did not differ in weight at the post-intervention follow-up (p=0.839). There was no significant difference between the groups in IGF-I or IGFBP-3. Conclusions: A diet and exercise intervention delivered during and after chemotherapy can promote weight loss in breast cancer patients, but the results may not be sustained after the intervention ends. [caption]Participants’ weights in kilograms, adjusted for baseline weight (least squares means).[caption] [Table: see text]

scholarly journals Effectiveness of a brief behavioural intervention to prevent weight gain over the Christmas holiday period: randomised controlled trial

BMJ ◽  
2018 ◽  
pp. k4867 ◽  
Author(s):  
Frances Mason ◽  
Amanda Farley ◽  
Miranda Pallan ◽  
Alice Sitch ◽  
Christina Easter ◽  
...  
Keyword(s):  
Weight Gain ◽  
Confidence Interval ◽  
Controlled Trial ◽  
Behavioural Intervention ◽  
Prevent Weight Gain ◽  
Comparator Group ◽  
Holiday Period ◽  
Baseline Weight ◽  
Randomised Controlled

Abstract Objective To test the effectiveness of a brief behavioural intervention to prevent weight gain over the Christmas holiday period. Design Two group, double blinded randomised controlled trial. Setting Recruitment from workplaces, social media platforms, and schools pre-Christmas 2016 and 2017 in Birmingham, UK. Participants 272 adults aged 18 years or more with a body mass index of 20 or more: 136 were randomised to a brief behavioural intervention and 136 to a leaflet on healthy living (comparator). Baseline assessments were conducted in November and December with follow-up assessments in January and February (4-8 weeks after baseline). Interventions The intervention aimed to increase restraint of eating and drinking through regular self weighing and recording of weight and reflection on weight trajectory; providing information on good weight management strategies over the Christmas period; and pictorial information on the physical activity calorie equivalent (PACE) of regularly consumed festive foods and drinks. The goal was to gain no more than 0.5 kg of baseline weight. The comparator group received a leaflet on healthy living. Main outcome measures The primary outcome was weight at follow-up. The primary analysis compared weight at follow-up between the intervention and comparator arms, adjusting for baseline weight and the stratification variable of attendance at a commercial weight loss programme. Secondary outcomes (recorded at follow-up) were: weight gain of 0.5 kg or less, self reported frequency of self weighing (at least twice weekly versus less than twice weekly), percentage body fat, and cognitive restraint of eating, emotional eating, and uncontrolled eating. Results Mean weight change was −0.13 kg (95% confidence interval −0.4 to 0.15) in the intervention group and 0.37 kg (0.12 to 0.62) in the comparator group. The adjusted mean difference in weight (intervention−comparator) was −0.49 kg (95% confidence interval −0.85 to −0.13, P=0.008). The odds ratio for gaining no more than 0.5 kg was non-significant (1.22, 95% confidence interval 0.74 to 2.00, P=0.44). Conclusion A brief behavioural intervention involving regular self weighing, weight management advice, and information about the amount of physical activity required to expend the calories in festive foods and drinks prevented weight gain over the Christmas holiday period. Trial registration ISRCTN Registry ISRCTN15071781 .

scholarly journals Psychopharmacology and adverse effects of antipsychotic long-acting injections: A review

2009 ◽  
Vol 195 (S52) ◽  
pp. s13-s19 ◽  
Author(s):  
David Taylor
Keyword(s):  
Weight Gain ◽  
Adverse Effects ◽  
Movement Disorders ◽  
First Generation ◽  
Second Generation ◽  
High Rate ◽  
Metabolic Effects ◽  
Using Data ◽  
Long Acting ◽  
First And Second Generation

BackgroundDepot antipsychotics are widely used in clinical practice. Long-acting formulations of second-generation antipsychotics are now being developed and introduced.AimsTo review the pharmacology, pharmacokinetics and adverse effect profiles of currently available antipsychotic long-acting injections (LAIs).MethodThe psychopharmacological properties of first- and second-generation antipsychotic LAIs are reviewed using data available up to October 2008.ResultsFirst-generation antipsychotic (FGA) LAIs are associated with a high rate of acute and chronic movement disorders. Risperidone LAI is better tolerated in this respect, but is associated with hyperprolactinaemia and weight gain. Olanzapine LAI causes weight gain and other metabolic effects but appears not to be associated with an important incidence of movement disorders.ConclusionsDosing of LAIs is complicated by delayed release of drug, changes in plasma levels without change in dose, and by the lack of data establishing clear dose requirements. All LAIs offer the prospect of assured adherence (although patients may still default on treatment) but their use is complicated by adverse effects, complex pharmacokinetics and confusion over dose–response relationships.

Safety concerns associated with second-generation antipsychotic long-acting injection treatment. A systematic update

2017 ◽  
Vol 36 (2) ◽  
Author(s):  
Salvatore Gentile
Keyword(s):  
Clinical Practice ◽  
Weight Gain ◽  
Second Generation ◽  
Safety Data ◽  
Paliperidone Palmitate ◽  
Cochrane Library ◽  
Pharmacological Intervention ◽  
Psychotic Symptoms ◽  
Second Generation Antipsychotic ◽  
Long Acting

Abstract Background It has been recently suggested that second-generation antipsychotic long-acting injection (SGA-LAIs) are underutilized in clinical practice, despite that their costs significantly impact on national health system budgets. Hence, an updated analysis of safety data shown by SGA-LAIs may contribute to clarify their role in clinical practice. Materials and methods English-language, peer-reviewed articles reporting updated, primary findings on the SGA-LAI safety were identified (updated through an electronic search of five databases – PubMed, EMBASE, PsycInfo, DARE and the Cochrane Library). Results The articles reviewed suggest that the most frequent treatment emergent adverse events (TEAEs) associated with aripiprazole long-acting injection (ARI-LAI) are psychotic symptoms, extrapyramidal symptoms (EPS) and weight gain. Data on olanzapine long-acting injection (OLA-LAI)-associated TEAEs highlight the risk of psychosis, metabolic disturbances and hyperprolactinemia. Four-hundred and forty cases of post-injection delirium/sedation syndrome (PDSS) have also been recorded. Although not reported in reviewed studies, the risk of impulse-control problem and drug reaction with eosinophilia and systemic symptoms (DRESS) ARI- and OLA-associated, respectively, must not be underestimated. With regards paliperidone palmitate 1-month formulation (PP1), the high incidence of clinically relevant weight gain and hyperprolactinemia are both findings of concern. Reviewed data also confirm that the leading cause of death in risperidone long-acting injection (RIS-LAI) clinical trials is suicide. The new 3-month paliperidone palmitate formulation, risperidone sustained release 1-month formulation (RIS-SR1), aripiprazole lauroxil (ARI-LXL) are still lacking exhaustive safety data. Conclusion The risk of specific TEAEs associated with all SGA-LAIs confirms SGA-LAIs do not offer advantages in safety compared with FGA-LAIs or oral antipsychotics and, especially, in early-phase schizophrenia patients. Implementing non pharmacological intervention and strategies can be effective for people with schizophrenia and bipolar disorder who adhere poorly to medication regimens.

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