Dopamine receptor D2 gene is associated with weight gain in schizophrenic patients under long-term atypical antipsychotic treatment

Background: Previous studies of atypical antipsychotic effects on cortical structures in schizophrenia (SZ) and bipolar disorder (BD) have findings that vary between the short and long term. In particular, there has not been a study exploring the effects of atypical antipsychotics on age-related cortical structural changes in SZ and BD. This study aimed to determine whether mid- to long-term atypical antipsychotic treatment (mean duration = 20 months) is associated with cortical structural changes and whether age-related cortical structural changes are affected by atypical antipsychotics.Methods: Structural magnetic resonance imaging images were obtained from 445 participants consisting of 88 medicated patients (67 with SZ, 21 with BD), 84 unmedicated patients (50 with SZ, 34 with BD), and 273 healthy controls (HC). Surface-based analyses were employed to detect differences in thickness and area among the three groups. We examined the age-related effects of atypical antipsychotics after excluding the potential effects of illness duration.Results: Significant differences in cortical thickness were observed in the frontal, temporal, parietal, and insular areas and the isthmus of the cingulate gyrus. The medicated group showed greater cortical thinning in these regions than the unmediated group and HC; furthermore, there were age-related differences in the effects of atypical antipsychotics, and these effects did not relate to illness duration. Moreover, cortical thinning was significantly correlated with lower symptom scores and Wisconsin Card Sorting Test (WCST) deficits in patients. After false discovery rate correction, cortical thinning in the right middle temporal gyrus in patients was significantly positively correlated with lower HAMD scores. The unmedicated group showed only greater frontotemporal thickness than the HC group.Conclusion: Mid- to long-term atypical antipsychotic use may adversely affect cortical thickness over the course of treatment and ageing and may also result in worsening cognitive function.

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P.3.d.017 Prevalence and predictors of the metabolic syndrome in patients on the long term atypical antipsychotic treatment

European Neuropsychopharmacology ◽

10.1016/s0924-977x(15)30669-6 ◽

2015 ◽

Vol 25 ◽

pp. S490

Author(s):

I. Popovic ◽

D. Ravanic ◽

S. Djukic-Dejanovic ◽

S. Jankovic ◽

V. Popovic

Keyword(s):

Metabolic Syndrome ◽

Atypical Antipsychotic ◽

Antipsychotic Treatment ◽

The Metabolic Syndrome

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PM441. Long term atypical antipsychotic treatment improves cognitive performance in schizophrenia but not surpassing conventional antipsychotic drugs effects.

The International Journal of Neuropsychopharmacology ◽

10.1093/ijnp/pyw041.441 ◽

2016 ◽

Vol 19 (Suppl_1) ◽

pp. 60-61

Keyword(s):

Cognitive Performance ◽

Atypical Antipsychotic ◽

Antipsychotic Drugs ◽

Antipsychotic Treatment ◽

Conventional Antipsychotic

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Long-term antipsychotic treatment in schizophrenia: systematic review and network meta-analysis of randomised controlled trials

BJPsych Open ◽

10.1192/bjpo.bp.115.002576 ◽

2016 ◽

Vol 2 (1) ◽

pp. 59-66 ◽

Cited By ~ 21

Author(s):

Ying Jiao Zhao ◽

Liang Lin ◽

Monica Teng ◽

Ai Leng Khoo ◽

Lay Beng Soh ◽

...

Keyword(s):

Weight Gain ◽

Adverse Effects ◽

Randomised Controlled Trials ◽

Antipsychotic Drugs ◽

Meta Analysis ◽

Antipsychotic Treatment ◽

Controlled Trials ◽

Fluphenazine Decanoate ◽

Randomised Controlled

BackgroundFor treatment of patients diagnosed with schizophrenia, comparative long-term effectiveness of antipsychotic drugs to reduce relapses when minimising adverse effects is of clinical interest, hence prompting this review.AimsTo evaluate the comparative long-term effectiveness of antipsychotic drugs.MethodWe systematically searched electronic databases for reports of randomised controlled trials (RCTs) of antipsychotic monotherapy aimed at reducing relapse risks in schizophrenia. We conducted network meta-analysis of 18 antipsychotics and placebo.ResultsStudies of 10 177 patients in 56 reports were included; treatment duration averaged 48 weeks (range 4–156). Olanzapine was significantly more effective than chlorpromazine (odds ratio (OR) 0.35, 95% CI 0.14–0.88) or haloperidol (OR=0.50, 95% CI 0.30–0.82); and fluphenazine decanoate was more effective than chlorpromazine (OR=0.31, 95% CI 0.11–0.88) in relapse reduction. Fluphenazine decanoate, haloperidol, haloperidol decanoate and trifluoperazine produced more extrapyramidal adverse effects than olanzapine or quetiapine; and olanzapine was associated with more weight gain than other agents.ConclusionsExcept for apparent superiority of olanzapine and fluphenazine decanoate over chlorpromazine, most agents showed intermediate efficacy for relapse prevention and differences among them were minor. Typical antipsychotics yielded adverse neurological effects, and olanzapine was associated with weight gain. The findings may contribute to evidence-based treatment selection for patients with chronic psychotic disorders.

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