Factors Influencing Acute Weight Change in Patients With Schizophrenia Treated With Olanzapine, Haloperidol, or Risperidone
J Clin Psychiatry 2001;62(4):231-238
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: Clinical factors predicting weight
change in patients with schizophrenia and related disorders
during acute treatment with the antipsychotic drugs olanzapine,
risperidone, and haloperidol were sought through retrospective
Method: Six-week body-weight data from 2 trials,
study 1 comparing olanzapine and haloperidol (N = 1369) and study
2 olanzapine and risperidone (N = 268), were analyzed. Effects of
8 clinically relevant covariates--therapy, clinical outcome
(Brief Psychiatric Rating Scale), baseline body mass index
(BBMI), increased appetite, age, gender, race, and dose--on
weight were compared.
Results: In study 1, olanzapine (vs.
haloperidol) therapy, better clinical outcome, lower BBMI, and
nonwhite race significantly affected weight gain. Effects of
increased appetite and male gender on weight gain were
significant for olanzapine but not for haloperidol. In study 2,
better clinical outcome, lower BBMI, and younger age
significantly affected weight gain. Increased appetite was more
frequent during olanzapine treatment than during haloperidol, but
not significantly different from risperidone. Significant
differences in effect on weight change were found between
olanzapine and haloperidol but not between olanzapine and
risperidone. No evidence was found that lower antipsychotic drug
doses were associated with lower weight gain.
Conclusion: This report identifies
predictive factors of acute weight change in patients with
schizophrenia. Similar factors across antipsychotic drugs in
predicting greater weight gain included better clinical outcome,
low BBMI, and nonwhite race. Factors differing between
conventional (haloperidol) and atypical (olanzapine) agents
included increased appetite and gender. Choice of atypical
antipsychotic drug (olanzapine vs. risperidone) was of minor
importance with regard to influence on acute weight gain.