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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Olanzapine treatment has been associated with clinically meaningful weight increases, hypertriglyceridemia, insulin resistance, and diabetes mellitus. There are few options for olanzapine responders who fail other antipsychotic agents. Aripiprazole is a potent (high-affinity) partial agonist at D2 and 5-HT1A receptors and a potent antagonist at 5-HT2A receptor and is associated with less weight gain than olanzapine. We report the results of a 10-week placebo-controlled, double-blind crossover study that examined 15 mg/d aripiprazole's effects on weight, lipids, glucose metabolism, and psychopathology in overweight and obese schizophrenia and schizoaffective disorder subjects treated with a stable dose of olanzapine. During the 4 weeks of aripiprazole treatment, there were significant decreases in weight (P = 0.003) and body mass index (P = 0.004) compared with placebo. Total serum cholesterol (P = 0.208), high-density lipoprotein cholesterol (HDL-C; P = 0.99), HDL-2 (P = 0.08), HDL-3 (P = 0.495), and low-density lipoprotein cholesterol (P = 0.665) did not change significantly comparing aripiprazole treatment to placebo treatment. However, total serum triglycerides (P = 0.001), total very low-density lipoprotein cholesterol (VLDL-C; P = 0.01), and VLDL-1C and VLDL-2C (P = 0.012) decreased significantly during the aripiprazole treatment phase. The VLDL-3C tended lower during aripiprazole, but the decrease was not significant (P = 0.062). There was a decrease in C-reactive protein comparing aripiprazole treatment to placebo, although it did not reach significance (P = 0.087). The addition of aripiprazole to a stable dose of olanzapine was well tolerated and resulted in significant improvements on several outcome measures that predict risk for medical morbidity.
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PMID:Aripiprazole added to overweight and obese olanzapine-treated schizophrenia patients. 2063 76

Patients with severe mental illnesses such as bipolar disorder and schizophrenia have significantly increased rates of early mortality compared with the general population. Increased mortality in the mentally ill is often due to medical comorbidities associated with overweight or obesity. Weight gain can be associated with the mental disorder itself or with the pharmacotherapy used to treat the mental disorder. Effective weight-neutral and weight-reducing medical agents are available, and the use of an appropriate pharmacotherapy regimen with behavior modification and patient education may help manage body weight in patients with serious mental illnesses.
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PMID:Managing weight gain in patients with severe mental illness. 1965 69

In recent years, there has been an increase in obesity in the general population in both adults and children. Certain mental disorders have been found to co-occur with overweight and obesity. These include binge-eating disorder and bulimia nervosa (nonpurging type), bipolar disorder, certain forms of major depressive disorder, and some severe, chronic mental illness (ie, schizophrenia and schizoaffective disorder). At the same time, some studies have also found that obesity co-occurs with certain mental disorders--specifically binge-eating disorder and mood disorders in females. The co-occurrence of psychiatric disorders (ie, mood and psychotic disorders), binge eating, and overweight or obesity has important public health implications for the treatment of patients with mental disorders, especially since many psychotropic agents can have adverse effects on appetite, binge eating, and weight. Physicians need to keep 2 key points in mind: 1) The treatment of mental disorders in patients with obesity may be different from the treatment of such patients who are not obese, and 2) The treatment of obesity that co-occurs with psychopathology may be different from obesity that is not comorbid with psychopathology.
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PMID:The relationship between severe mental illness and obesity. 1966 51

For patients with mental illness, the purpose of antipsychotic medication is to improve their quality of life, and for many, quality of life improves dramatically with treatment. However, weight gain in the range of 7 to 10% is commonly associated with the use of antipsychotic medications and can have a negative impact on patient quality of life. Being overweight or obese can lead to serious medical conditions, including insulin resistance, diabetes mellitus, hypertension, dyslipidemia, arthritis and coronary heart disease. The physical and psychological consequences of weight gain are an added burden for patients with schizophrenia or other mental disorders. Successful strategies to prevent and manage weight gain include diet and exercise interventions and, in some cases, switching to a different antipsychotic agent.
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PMID:Quality of life issues associated with antipsychotic-induced weight gain. 1980 98

Being overweight or obese are medical conditions that are very difficult to treat. There is compelling evidence that obesity is commonly seen in patients with schizophrenia. Recently, a number of publications have focused on the ability of atypical antipsychotic drugs to induce obesity. All antipsychotic drugs produce weight gain, but their potential varies. Many studies overwhelmingly confirm that atypical antipsychotic drugs produce substantially more weight gain in comparison with typical antipsychotic drugs. Clozapine and olanzapine have the most weight-inducing potential. Even ziprasidone, which is considered to be weight neutral, produces weight gain in some patients. The pathophysiology of weight gain is complicated. Many neurohormones, neuropeptides and intestinal hormones, as well as adipose tissue and hair root-derived hormones, interact with environmental factors to produce weight gain. The basis of weight-gain treatment is an understanding of the etiology. Drug-induced obesity provides a unique opportunity to psychiatrists to understand this true psychosomatic problem. In the absence of this knowledge, prevention is the best hope. Education, diet control and simple behavioral measures may prevent excessive weight gain. In those with weight gain, treatment can be attempted with pharmacotherapy.
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PMID:Weight gain associated with atypical antipsychotic drugs: mechanisms and management. 1981 Aug 48

Switching to a different second-generation antipsychotic (SGA) with a lower risk of weight gain is recommended for overweight or obese psychiatric patients undergoing SGA treatment. However, there have been no complete reports regarding the long-term metabolic effects of switching to amisulpride. In this open-label 1-year study, we investigated the effects on body weight and other metabolic profiles when psychiatric patients treated with another SGA were switched to amisulpride treatment. Forty-six schizophrenia or schizoaffective inpatients with a body mass index greater than 27 kg/m were enrolled in the switch group. These patients were cross-titrated to amisulpride treatment and followed up for 1 year prospectively. Another 46 inpatients matched with the baseline body mass index of those in the switch group were enrolled as the control group retrospectively. The results showed that the switch group had greater weight loss than the control group (7.80 +/- 6.67 vs 2.60 +/- 6.23 kg, respectively; repeated-measure analysis of variance, P < 0.0005). During the treatment course, the amisulpride-treated patients showed significantly decreased fasting triglyceride, total cholesterol, glucose, and insulin resistance levels; decreased diastolic blood pressure and pulse rate; and a significant increase in high-density lipoprotein cholesterol levels after switching to amisulpride (all with a P < 0.05). The prevalence of metabolic syndrome in amisulpride-treated patients also decreased significantly from 65.2% to 30.4% (McNemar test, P < 0.0005). These findings suggest that switching to amisulpride could be an effective treatment of overweight or obese psychiatric patients treated previously with other SGAs.
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PMID:Improved body weight and metabolic outcomes in overweight or obese psychiatric patients switched to amisulpride from other atypical antipsychotics. 1991 Jul 16

People with schizophrenia have an increased prevalence of overweight/obesity, type 2 diabetes mellitus, dyslipidemia, and metabolic syndrome, which increases the risk for cardiovascular diseases and mortality. Part of this increased risk is attributable to the use of antipsychotic medications, especially second-generation antipsychotics. Antipsychotic drugs differ in their potential to induce weight gain, with clozapine and olanzapine exhibiting the highest weight gain liability; evidence for differing effects of antipsychotics on glucose and lipid metabolism is less convincing. Individuals with schizophrenia may develop hyperprolactinemia, with or without clinical symptoms, after starting antipsychotic medications. This effect is particularly frequent with first-generation antipsychotics and with the second-generation antipsychotic risperidone and paliperidone. Psychiatrists should be aware of metabolic and endocrine side effects of antipsychotics and should make every effort to prevent or minimize them to improve the patients' compliance and quality of life.
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PMID:Management of schizophrenia with obesity, metabolic, and endocrinological disorders. 1994 83

The aim of this study was to assess the occurrence of tobacco smoking and obesity in 58 schizophrenia women aged 45.1 +/- 9.9 years. 72% of women declared tobacco dependence as well as 14% smoked dependently on mood and 14% didn't smoke. There were statistically significant differences between women whose smoke or not in the case of BMI. The smoking women had significant higher BMI than non-smoking women (27.81 +/- 3.51 vs. 22.35 +/- 4.29, respectively). We didn't observe such comparisons between period smoking women and smoking women as well as non-smoking women. In the case of frequency distribution of schizophrenia women according to BMI we observed significant differences in this parameter. In the little underweight women (BMI below 20, n = 5) 60% didn't smoke. In the group of normal weight women (BMI = 21-25, n = 14) 64% smoked and 22% didn't. In the groups of overweight women (BMI = 26-30, n = 28) and obese women (BMI > 30) most of them were smoked. In the first of those groups 79% were smoking women and only 7% nonsmoking as well as in the second--all of women were smoked. These results show that the tobacco dependence and obesity could strongly correlate in schizophrenia and we need more studies in this case.
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PMID:[The occurrence of tobacco smoking and obesity in schizophrenia women]. 2030 24

Elevated blood levels of S100B in schizophrenia have so far been mainly attributed to glial pathology, as S100B is produced by astro- and oligodendroglial cells and is thought to act as a neurotrophic factor with effects on synaptogenesis, dopaminergic and glutamatergic neutrotransmission. However, adipocytes are another important source of S100B since the concentration of S100B in adipose tissue is as high as in nervous tissue. Insulin is downregulating S100B in adipocytes, astrocyte cultures and rat brain. As reviewed in this paper, our recent studies suggest that overweight, visceral obesity, and peripheral/cerebral insulin resistance may be pivotal for at least part of the elevated S100B serum levels in schizophrenia. In the context of this recently identified framework of metabolic disturbances accompanying S100B elevation in schizophrenia, it rather has to be attributed to systemic alterations in glucose metabolism than to be considered a surrogate marker for astrocyte-specific pathologies.
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PMID:S100B Serum Levels in Schizophrenia Are Presumably Related to Visceral Obesity and Insulin Resistance. 2063 94

Patients with schizophrenia have a greater incidence of being overweight or obese compared with the general population. Such individuals are often treated with second-generation (atypical) antipsychotics (SGAs), which are associated with weight gain, dyslipidemia, and other metabolic derangements. As a result, frequent monitoring of weight and other metabolic parameters is recommended. In addition, several pharmacologic strategies to help prevent or reduce SGA-induced weight gain have been proposed. Despite this, clinicians often struggle to manage obesity and metabolic issues in such patients. Metformin has attracted attention as a potential treatment option because it is thought to result in weight reduction and improved glycemic control in obese patients with and without type 2 diabetes mellitus. This article focuses on relevant pharmacologic aspects of metformin and reviews currently available evidence on the use of metformin as an augmentation agent for the treatment or prevention of SGA-induced weight gain.
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PMID:The adjunctive use of metformin to treat or prevent atypical antipsychotic-induced weight gain: a review. 2085 6


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