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PSYCHIATRY

Weight Change After an Atypical Antipsychotic Switch

Associate Professor, College of Pharmacy, University of Florida, Gainesville, FL; Research Health Scientist, Rehabilitation Outcomes Research Center, Malcom Randall Veterans Affairs Medical Center, Gainesville

Bernard T Renner, BS

PharmD Student, College of Pharmacy, University of Florida

Michael A Bengtson, MD

Assistant Professor, Department of Psychiatry, College of Medicine, University of Florida; Psychiatrist, Department of Psychiatry, Malcom Randall Veterans Affairs Medical Center

Brian M Wilcox, PharmD

Pharmacist Specialist, Department of Pharmacy, Malcom Randall Veterans Affairs Medical Center

Wilfred W Acholonu, Jr, PharmD BCPP

Pharmacist Specialist, Department of Pharmacy, Malcom Randall Veterans Affairs Medical Center

Reprints: L Douglas Ried PhD, PO Box 100496, University of Florida, Gainesville, FL 32610-0496, FAX 352/273-6270, ried{at}cop.ufl.edu

BACKGROUND: Atypical antipsychotics successfully treat schizophrenia and other conditions, with a lower incidence of extrapyramidal side effects than other agents used in treatment of these disorders. However, some atypical antipsychotics are associated with weight gain.

OBJECTIVE: To quantify the impact on weight and identify atypical antipsychotics causing the least amount of weight gain among patients switched from risperidone to olanzapine and olanzapine to risperidone.

METHODS: Patients included in the study (n = 86) were 18 years and had received 2 prescriptions for risperidone or olanzapine for 60 days, switched to the other atypical antipsychotic, and were dispensed 2 prescriptions for at least 60 days after the index date. Age, weight, and body mass index (BMI) were retrospectively abstracted from automated databases containing patient-specific prescription and vital sign information.

RESULTS: At the time of their switch, the average patient age was 53.2 years (range 25-83). The average weight change in patients switched to olanzapine (n = 47) was +2.3 kg (p = 0.01) and the BMI change was +0.8 kg/m² (p = 0.02). The average percent body weight change was +2.8% and the BMI change was +3.0%. The average weight change after patients switched to risperidone (n = 39) was -0.45 kg (p = 0.69) and BMI change was -0.2 kg/m² (p = 0.64). The average percentage weight change was -0.4% and BMI change was -0.5%.

CONCLUSIONS: Practitioners' concern regarding weight changes after switching atypical antipsychotics seems warranted and patients should be provided consistent, ongoing weight monitoring. Further investigations should examine whether weight changes associated with atypical antipsychotic treatment further jeopardize this already at-risk population for severe comorbid conditions such as hypertension, coronary artery disease, and type 2 diabetes.

Key Words: atypical antipsychotics, olanzapine, risperidone, weight gain

Published Online, July 17, 2003. www.theannals.com, DOI 10.1345/aph.1C470

This article has been cited by other articles:

				E K. Hester and M. R Thrower Current Options in the Management of Olanzapine-Associated Weight Gain Ann. Pharmacother., February 1, 2005; 39(2): 302 - 310. [Abstract] [Full Text] [PDF]