scholarly journals Topiramate Adjunctive Therapy for Olanzapine Induced Weight Gain in Patients with Schizophrenia

2019 ◽  
Vol 2 (2) ◽  
pp. 147-150
Author(s):  
Sanjib Pandit
Keyword(s):  
Weight Gain ◽  
Energy Homeostasis ◽  
Atypical Antipsychotics ◽  
Schizophrenia Patient ◽  
Healthy Male ◽  
H1 Receptor ◽  
Receptor Affinity ◽  
Conventional Antipsychotics ◽  
Disease Spectrum ◽  
Second Generation Antipsychotics

In recent days, the prevailing use of second generation antipsychotics (SGA) or atypical antipsychotics over conventional antipsychotics have shifted the concern of physician from extra pyramidal side effects to the weight gain in the patients receiving treatment for schizophrenia. Among others atypical anti-psychotics, the phenomenology of Olanzapine related weight gain is highly recognized in the clinical practice. However, the exact mechanism by which Olanzapine exerts weight gain effect is largely not understood and is very likely to be multi-factorial. Among other several risk factors, factors such as 5HT2c polymorphisms and H1 receptor affinity have also been purposed. Similarly, various neuro-endocrinal factors related in maintaining energy homeostasis have also been observed to be affected by Olanzapine treatment. However no consisting findings are available to clearly explain the underlying psycho-pathology of disease spectrum in schizophrenia. However, though, recent finding from a clinical trial carried out in healthy male volunteers have suggested that the low baseline TSH profile predicts Olanzapine related weight gain and also interestingly relief by Topiramate adjuvant therapy. However, no such investigations were found in schizophrenia patient.

scholarly journals H1-Histamine Receptor Affinity Predicts Short-Term Weight Gain for Typical and Atypical Antipsychotic Drugs

2003 ◽  
Vol 28 (3) ◽  
pp. 519-526 ◽  
Author(s):  
Wesley K Kroeze ◽  
Sandra J Hufeisen ◽  
Beth A Popadak ◽  
Sean M Renock ◽  
SeAnna Steinberg ◽  
...  
Keyword(s):  
Weight Gain ◽  
Atypical Antipsychotic ◽  
Antipsychotic Drugs ◽  
Histamine Receptor ◽  
Short Term ◽  
Receptor Affinity ◽  
Atypical Antipsychotic Drugs

The treatment of mixed states and the risk of switching to depression

2005 ◽  
Vol 20 (2) ◽  
pp. 96-100 ◽  
Author(s):  
Eduard Vieta
Keyword(s):  
Clinical Trials ◽  
Depressive Symptoms ◽  
Mixed State ◽  
Atypical Antipsychotics ◽  
Randomized Clinical Trials ◽  
Mixed States ◽  
Conventional Antipsychotics

AbstractThere are few controlled studies evaluating the treatment of bipolar mixed states. Evidence suggests that mixed states may be more responsive to some anticonvulsants than to lithium. Olanzapine alone or in combination with divalproate or lithium has been adequately evaluated in randomized clinical trials involving mixed-state patients, whereas risperidone and quetiapine have not. There is also some evidence demonstrating the efficacy of ziprasidone and aripiprazole. The risk of switching to depression is high in mixed states. Conventional antipsychotics, such as haloperidol, may be less efficacious at protecting against a switch to depression than atypical antipsychotics, divalproate or lithium. When choosing drugs for the treatment of mania, and especially for the treatment of mixed states, their efficacy against manic and depressive symptoms, and their safety in terms of the risk of switching to depression should be taken into account.

scholarly journals Neonatal nutritional programming impairs adiponectin effects on energy homeostasis in adult life of male rats

2018 ◽  
Vol 315 (1) ◽  
pp. E29-E37 ◽  
Author(s):  
Mariana Peduti Halah ◽  
Paula Beatriz Marangon ◽  
Jose Antunes-Rodrigues ◽  
Lucila L. K. Elias
Keyword(s):  
Body Weight ◽  
Adipose Tissue ◽  
Weight Gain ◽  
Food Intake ◽  
White Adipose Tissue ◽  
Energy Homeostasis ◽  
Body Weight Gain ◽  
Adult Life ◽  
Male Rats ◽  
Nutritional Programming

Neonatal nutritional changes induce long-lasting effects on energy homeostasis. Adiponectin influences food intake and body weight. The aim of this study was to investigate the effects of neonatal nutritional programming on the central stimulation of adiponectin. Male Wistar rats were divided on postnatal (PN) day 3 in litters of 3 (small litter, SL), 10 (normal litter, NL), or 16 pups/dam (large litter, LL). We assessed body weight gain for 60 days, adiponectin concentration, and white adipose tissue weight. We examined the response of SL, NL, and LL rats on body weight gain, food intake, oxygen consumption (V̇o2), respiratory exchange ratio (RER), calorimetry, locomotor activity, phosphorylated-AMP-activated protein kinase (AMPK) expression in the hypothalamus, and uncoupling protein (UCP)-1 in the brown adipose tissue after central stimulus with adiponectin. After weaning, SL rats maintained higher body weight gain despite similar food intake compared with NL rats. LL rats showed lower body weight at weaning, with a catch up afterward and higher food intake. Both LL and SL groups had decreased plasma concentrations of adiponectin at PN60. SL rats had increased white adipose tissue. Central injection of adiponectin decreased body weight and food intake and increased V̇o2, RER, calorimetry, p-AMPK and UCP- 1 expression in NL rats, but it had no effect on SL and LL rats, compared with the respective vehicle groups. In conclusion, neonatal under- and overfeeding induced an increase in body weight gain in juvenile and early adult life. Unresponsiveness to central effects of adiponectin contributes to the imbalance of the energy homeostasis in adult life induced by neonatal nutritional programming.

scholarly journals Are Atypical Antipsychotics the Least Detrimental Alternative?

2019 ◽  
Vol 16 (1) ◽  
pp. 91-104
Author(s):  
Holly Breton
Keyword(s):  
Metabolic Syndrome ◽  
Side Effect ◽  
Atypical Antipsychotics ◽  
First Generation ◽  
Extrapyramidal Symptoms ◽  
Treatment Resistant ◽  
Major Depressive ◽  
Second Generation Antipsychotics ◽  
Potential Risks ◽  
Decrease Life Expectancy

Antipsychotics are typically used for the treatment of schizophrenia, bipolar disorder, and recently, treatment resistant major depressive disorder.  A significant, and very concerning, side effect present with first generation antipsychotics is extrapyramidal symptoms, which are disorders of movement. With the advent of atypical antipsychotics, also known as second-generation antipsychotics, these symptoms are purported to be much less frequent and pronounced than they were with the first generation medications.  Numerous hypotheses have been proposed as to why atypical antipsychotics produce fewer extrapyramidal symptoms compared to first generation antipsychotics, which this paper will review. Unfortunately, despite the fact that atypicals have reduced extrapyramidal symptoms in those taking antipsychotics, extrapyramidal symptoms are still an unpleasant and potentially dangerous side effect, which can be difficult to detect, and difficult, or even impossible, to treat.  Additionally, atypical antipsychotics result in other potentially very serious side effects, specifically and most commonly, metabolic syndrome, which can decrease life expectancy significantly. However, metabolic syndrome, unlike extrapyramidal symptoms, may be preventable in highly motivated and well-supported patients. Thus, this paper concludes that the benefits of the atypical antipsychotics (reduced extrapyramidal symptoms) outweigh the potential risks for the majority of patients.

Psychosis

2019 ◽  
pp. 150-151
Author(s):  
David L. Brody
Keyword(s):  
Young Adults ◽  
Weight Gain ◽  
Drug Abuse ◽  
Side Effects ◽  
Sleep Deprivation ◽  
Outpatient Treatment ◽  
Atypical Antipsychotics ◽  
Psychiatric Service ◽  
Safety First ◽  
Cognitive Side Effects

New onset hallucinations and delusions are rare after isolated concussion and should trigger a search for other causes: Schizophrenia (relatively common in young adults), drug abuse, alcohol or drug withdrawal, and delirium due to infection or sleep deprivation should be considered. Importantly, if the psychosis is dangerous or potentially dangerous, think about safety first. This may require inpatient admission to a psychiatric service. If outpatient treatment is required, atypical antipsychotics should be used in as low a dose as possible to minimize cognitive side effects. Aripiprazole (Abilify) is associated with less weight gain than other atypical antipsychotics. Risperidone (Risperdal) is the least expensive. Quetiapine (Seroquel), or rarely Clozaril, are the best choices when parkinsonism is a comorbidity.

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