Atypical Antipsychotic Induced Weight Gain in Schizophrenic Patients

Tetie Herlina, Dyah A. Perwitasari, Haafizah Dania, Santi Yuliani, Melisa I. Barliana

Abstract


Atypical antipsychotics are widely prescribed and have the potential to cause weight gain, which may result in the development of metabolic syndrome. Also, it is important to monitor the use of atypical antipsychotic for metabolic disturbance. The purpose of this study is to determine the side effects of atypical antipsychotics in increasing body weight in schizophrenia patients after 4 weeks of use. Furthermore, a retrospective design was conducted and data were collected based on consecutive sampling in 80 adult psychiatric inpatients (20 women and 60 men) with initial diagnoses of schizophrenia and with the same daily nutrition. The patients were hospitalized from January to March 2019, within the term (over 4 weeks) of initiation atypical antipsychotic. The patient body weight was collected before and 4 weeks after the treatment of atypical antipsychotic. The results showed that patients (20 women and 60 men) receiving atypical antipsychotic had a mean age of 35.6 years and a percentage of 70% women and 56% men had a weight gain of 1–5 kg over 4 weeks. The mean weight observed among our subjects increased from 57.55±10.743 kg to 59.83±12.205 kg after initiating treatment (p=0.001). However, the dual combination of atypical antipsychotics risperidone and clozapine are the most widely atypical antipsychotic used with a percentage equal to 91.25%, 3.75% clozapine, and 5% risperidone. Furthermore, it can be concluded that atypical antipsychotics use for at least 4 weeks can cause weight gain in schizophrenic patients. Pharmacist and doctors are recommended to monitor the metabolic side effects due to the atypical antipsychotic use.

 Keywords: Atypical antipsycotic, schizophrenia, weight gain 

 

Antipsikotik Atipikal Menginduksi Peningkatan Berat Badan pada Pasien Skizofrenia

 

Abstrak

Antipsikotik atipikal banyak diresepkan dan berpotensi menyebabkan kenaikan berat badan yang dapat menyebabkan sindrom metabolik. Ada kebutuhan klinis yang mendesak untuk memantau penggunaan antipsikotik atipikal terhadap gangguan metabolisme. Penelitian ini bertujuan untuk mengetahui efek samping antipsikotik atipikal dalam meningkatkan berat badan pada pasien skizofrenia setelah pemakaian 4 minggu. Melalui desain retrospektif, data dikumpulkan dengan consecutive sampling pada 80 pasien rawat inap psikiatri dewasa (20 wanita dan 60 pria) dengan diagnosis awal skizofrenia dan dengan pengaturan nutrisi harian yang sama. Pasien dirawat di rumah sakit sejak Januari 2019 sampai dengan Maret 2019, dalam jangka menengah (lebih dari 4 minggu) pemberian antipsikotik atipikal. Data berat badan pasien dicatat sebelum dan 4 minggu sesudah pemakaian antipsikotik atipikal. Pasien (20 wanita dan 60 pria) yang menerima antipsikotik atipikal memiliki usia rata-rata 35,6 tahun, semua pasien dengan persentase 70% wanita dan 56% pria memiliki kenaikan berat badan 1–5 kg selama periode 4 minggu. Berat rata-rata yang diamati di antara subyek meningkat dari 57,55±10,743 kg menjadi 59,83±12,205 kg setelah memulai pengobatan (p=0,001). Antipsikotik atipikal yang paling banyak digunakan adalah kombinasi antipsikotik atipikal risperidon clozapin dengan persentase sebesar 91,25%, clozapin 3,75%, risperidon 5%. Kami menyimpulkan bahwa penggunaan antipsikotik atipikal selama setidaknya 4 minggu dapat menyebabkan penambahan berat badan pada pasien skizofrenia. Apoteker dan dokter direkomendasikan untuk memantau efek samping metabolik akibat penggunaan antipsikotik atipikal.

Kata kunci: Antipsikotik atipikal, peningkatan berat badan, skizofrenia


Keywords


Atypical antipsychotic, schizophrenia, weight gain

Full Text:

PDF

References


Sriretnakumar V, Huang E, Müller DJ. Pharmacogenetics of clozapine treatment response and side-effects in schizophrenia: An update. Expert Opin Drug Metab Toxicol. 2015;11(11):1709–31. doi: 10.1517/17425255.2015.1075003

Meltzer HY. Update on typical and atypical antipsychotic drugs. Annu Rev Med. 2013;64(1):393–406. doi: 10.1146/annurev-med-050911-161504

Vasudev K, Choi Y-H, Norman R, Kim RB, Schwarz UI. Genetic determinants of clozapine-induced metabolic side effects. Can J Psychiatry. 2017;62(2):138–49. doi: 10.1177/0706743716670128

Mitchell AJ, Vancampfort D, De Herdt A, Yu W, De Hert M. Is the prevalence of metabolic syndrome and metabolic abnormalities increased in early schizophrenia? A comparative meta-analysis of first episode, untreated and treated patients. Schizophr Bull. 2013;39(2):295–305. doi: 10.1093/schbul/sbs082

Foley DL, Morley KI. Systematic review of early cardiometabolic outcomes of the first treated episode of psychosis. Arch Gen Psychiatry. 2011;68(6):609–16. doi: 10.1001/archgenpsychiatry.2011.2

Correll CU, Robinson DG, Schooler NR, Brunette MF, Mueser KT, Rosenheck RA, et al. Cardiometabolic risk in patients with first-episode schizophrenia spectrum disorders: Baseline results from the RAISE-ETP study. JAMA Psychiatry. 2014;71(12):1350–63. doi: 10.1001/jamapsychiatry.2014.1314

Aryani F, Sari O. Gambaran pola penggunaan antipsikotik pada pasien skizofrenia di ruang rawat inap rumah sakit jiwa. J Manaj Pelayan Farm. 2016;6(1):35–40. doi: 10.22146/jmpf.236

Indriani A, Ardiningrum W, Febrianti Y. Studi penggunaan kombinasi antipsikotik pada pasien skizofrenia di rumah sakit Yogyakarta. Maj Farmaset. 2019;4(1):201–11. doi: 10.24198/mfarmasetika.v4i0.25882

Prebawa IPAG, Witari PK, Ariawan, IWY. Gambaran sindrom metabolik pada pasien gangguan jiwa yang dirawat di rumah sakit jiwa provinsi Bali. Intisari Sains Medis. 2019;10(2):459–64. doi: 10.1556/ism.v10i2.456

Cooper SJ, Reynolds GP, Barnes T, England E, Haddad PM, Heald A, et al. BAP guidelines on the management of weight gain, metabolic disturbances and cardiovascular risk associated with psychosis and antipsychotic drug treatment. J Psychopharmacol. 2016;30(8):717–48 doi: 10.1177/0269881116645254

Gregoor JG, Mulder H, Cohen D, van Megen HGJM, Egberts TCG, Heerdink ER, et al. Combined HTR2C-LEP genotype as a determinant of obesity in patients using antipsychotic medication. J Clin Psychopharmacol. 2010;30(6):702–5. doi: 10.1097/JCP.0b013e3181fa05a2

Puangpetch A, Unaharassamee W, Jiratjintana N, Koomdee N, Sukasem C. Genetic polymorphisms of HTR2C, LEP and LEPR on metabolic syndromes in patients treated with atypical antipsychotic drugs. J Pharm Pharmacol. 2018;70(4):536–42. doi: 10.1111/jphp.12892

Kraemer S, Minarzyk A, Forst T, Kopf D, Hundemer H-P. Prevalence of metabolic syndrome in patients with schizophrenia, and metabolic changes after 3 months of treatment with antipsychotics--results from a German observational study. BMC Psychiatry. 2011;11(1):173. doi: 10.1186/1471-244X-11-173

Castellani LN, Costa-Dookhan KA, Mclntyre WB, Wright DC, Flowers SA, Hahn MK, et al. Preclinical and clinical sex differences in antipsychotic-induced metabolic disturbances: A narrative review of adiposity and glucose metabolism. J Psychiatr Brain Sci. 2019;4:e190013. doi: 10.20900/jpbs.20190013




DOI: https://doi.org/10.15416/ijcp.2021.10.1.57

Refbacks

  • There are currently no refbacks.


 Indonesian Journal of Clinical Pharmacy is indexed by

        

  Creative Commons License

IJCP by Universitas Padjadjaran is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

 

View My Stats