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Weight Gain and Metabolic Changes in Children and Adolescents Treated With Atypical Antipsychotics

(PSYCHIATRIC TIMES) - The results of a recent study showed that children and adolescents with serious mental illness treated with second-generation antipsychotic medications are likely to experience rapid weight gain.1 The majority of these treatments are also associated with metabolic changes, said lead study author, Christoph Correll, MD, medical director of the Recognition and Prevention Program at the Zucker Hillside Hospital, Glen Oaks, NY. “The weight gain we observed was much more rapid and dramatic than previously described,” he said in an interview with Drug Benefit Trends.

The study included patients with serious mental illness, aged 4 to 19 years, who had been treated for 1 week or less with second-generation antipsychotic medications. Of the 205 who completed the study, 47.8% had mood spectrum disorders, 30.1% had schizophrenia disorders, and 22.1% had disruptive or aggressive behavior spectrum disorders. After about 11 weeks of treatment, average weight increases in each treatment group were as follows: olanzapine, 8.5 kg; quetiapine, 6.1 kg; risperidone, 5.3 kg; aripiprazole, 4.4 kg. The average weight increase in those untreated was 0.2 kg (Figure).

Correll found it surprising that each medication seemed to have its own “cardiometabolic signature.” Treatment with olanzapine caused the largest change in body composition weight gain as well as the greatest changes in metabolic parameters. Quetiapine was associated with adverse effects on all lipid parameters, while risperidone only caused a significantly adverse effect on triglyceride levels. Aripriprazole was associated with weight gain but no significant metabolic changes. “

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