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Acute weight gain, gender, and therapeutic response to antipsychotics in the treatment of patients with schizophrenia

BACKGROUND: Previous research indicated that women are more vulnerable than men to adverse psychological consequences of weight gain. Other research has suggested that weight gain experienced during antipsychotic therapy may also psychologically impact women more negatively. This study assessed the...

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Autores principales: Ascher-Svanum, Haya, Stensland, Michael, Zhao, Zhongyun, Kinon, Bruce J
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2005
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC547901/
https://www.ncbi.nlm.nih.gov/pubmed/15649317
http://dx.doi.org/10.1186/1471-244X-5-3
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author Ascher-Svanum, Haya
Stensland, Michael
Zhao, Zhongyun
Kinon, Bruce J
author_facet Ascher-Svanum, Haya
Stensland, Michael
Zhao, Zhongyun
Kinon, Bruce J
author_sort Ascher-Svanum, Haya
collection PubMed
description BACKGROUND: Previous research indicated that women are more vulnerable than men to adverse psychological consequences of weight gain. Other research has suggested that weight gain experienced during antipsychotic therapy may also psychologically impact women more negatively. This study assessed the impact of acute treatment-emergent weight gain on clinical and functional outcomes of patients with schizophrenia by patient gender and antipsychotic treatment (olanzapine or haloperidol). METHODS: Data were drawn from the acute phase (first 6-weeks) of a double-blind randomized clinical trial of olanzapine versus haloperidol in the treatment of 1296 men and 700 women with schizophrenia-spectrum disorders. The associations between weight change and change in core schizophrenia symptoms, depressive symptoms, and functional status were examined post-hoc for men and women and for each medication group. Core schizophrenia symptoms (positive and negative) were measured with the Brief Psychiatric Rating Scale (BPRS), depressive symptoms with the BPRS Anxiety/Depression Scale and the Montgomery-Asberg Depression Rating Scale, and functional status with the mental and physical component scores on the Medical Outcome Survey-Short Form 36. Statistical analysis included methods that controlled for treatment duration. RESULTS: Weight gain during 6-week treatment with olanzapine and haloperidol was significantly associated with improvements in core schizophrenia symptoms, depressive symptoms, mental functioning, and physical functioning for men and women alike. The conditional probability of clinical response (20% reduction in core schizophrenia symptom), given a clinically significant weight gain (at least 7% of baseline weight), showed that about half of the patients who lost weight responded to treatment, whereas three-quarters of the patients who had a clinically significant weight gain responded to treatment. The positive associations between therapeutic response and weight gain were similar for the olanzapine and haloperidol treatment groups. Improved outcomes were, however, more pronounced for the olanzapine-treated patients, and more olanzapine-treated patients gained weight. CONCLUSIONS: The findings of significant relationships between treatment-emergent weight gain and improvements in clinical and functional status at 6-weeks suggest that patients who have greater treatment-emergent weight gain are more likely to benefit from treatment with olanzapine or haloperidol regardless of gender.
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spelling pubmed-5479012005-02-04 Acute weight gain, gender, and therapeutic response to antipsychotics in the treatment of patients with schizophrenia Ascher-Svanum, Haya Stensland, Michael Zhao, Zhongyun Kinon, Bruce J BMC Psychiatry Research Article BACKGROUND: Previous research indicated that women are more vulnerable than men to adverse psychological consequences of weight gain. Other research has suggested that weight gain experienced during antipsychotic therapy may also psychologically impact women more negatively. This study assessed the impact of acute treatment-emergent weight gain on clinical and functional outcomes of patients with schizophrenia by patient gender and antipsychotic treatment (olanzapine or haloperidol). METHODS: Data were drawn from the acute phase (first 6-weeks) of a double-blind randomized clinical trial of olanzapine versus haloperidol in the treatment of 1296 men and 700 women with schizophrenia-spectrum disorders. The associations between weight change and change in core schizophrenia symptoms, depressive symptoms, and functional status were examined post-hoc for men and women and for each medication group. Core schizophrenia symptoms (positive and negative) were measured with the Brief Psychiatric Rating Scale (BPRS), depressive symptoms with the BPRS Anxiety/Depression Scale and the Montgomery-Asberg Depression Rating Scale, and functional status with the mental and physical component scores on the Medical Outcome Survey-Short Form 36. Statistical analysis included methods that controlled for treatment duration. RESULTS: Weight gain during 6-week treatment with olanzapine and haloperidol was significantly associated with improvements in core schizophrenia symptoms, depressive symptoms, mental functioning, and physical functioning for men and women alike. The conditional probability of clinical response (20% reduction in core schizophrenia symptom), given a clinically significant weight gain (at least 7% of baseline weight), showed that about half of the patients who lost weight responded to treatment, whereas three-quarters of the patients who had a clinically significant weight gain responded to treatment. The positive associations between therapeutic response and weight gain were similar for the olanzapine and haloperidol treatment groups. Improved outcomes were, however, more pronounced for the olanzapine-treated patients, and more olanzapine-treated patients gained weight. CONCLUSIONS: The findings of significant relationships between treatment-emergent weight gain and improvements in clinical and functional status at 6-weeks suggest that patients who have greater treatment-emergent weight gain are more likely to benefit from treatment with olanzapine or haloperidol regardless of gender. BioMed Central 2005-01-13 /pmc/articles/PMC547901/ /pubmed/15649317 http://dx.doi.org/10.1186/1471-244X-5-3 Text en Copyright © 2005 Ascher-Svanum et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Ascher-Svanum, Haya
Stensland, Michael
Zhao, Zhongyun
Kinon, Bruce J
Acute weight gain, gender, and therapeutic response to antipsychotics in the treatment of patients with schizophrenia
title Acute weight gain, gender, and therapeutic response to antipsychotics in the treatment of patients with schizophrenia
title_full Acute weight gain, gender, and therapeutic response to antipsychotics in the treatment of patients with schizophrenia
title_fullStr Acute weight gain, gender, and therapeutic response to antipsychotics in the treatment of patients with schizophrenia
title_full_unstemmed Acute weight gain, gender, and therapeutic response to antipsychotics in the treatment of patients with schizophrenia
title_short Acute weight gain, gender, and therapeutic response to antipsychotics in the treatment of patients with schizophrenia
title_sort acute weight gain, gender, and therapeutic response to antipsychotics in the treatment of patients with schizophrenia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC547901/
https://www.ncbi.nlm.nih.gov/pubmed/15649317
http://dx.doi.org/10.1186/1471-244X-5-3
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