Effects of Patient Demographics, Risperidone Dosage, and Clinical Outcome on Body Weight in Acutely Exacerbated Schizophrenia
J Clin Psychiatry 2003;64(3):316-320
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Predictors for risperidone-related
weight gain remain unclear. This study aimed to identify clinical
factors influencing body weight in risperidone-treated patients.
Method: One hundred forty-six newly hospitalized
DSM-IV schizophrenia patients with acute exacerbation entered
this prospective, 6-week, repeated-measures trial. The mean ± SD
risperidone dose was 4.3 ± 1.4 mg/day at week 6. Efficacy, body
weight, and tolerability were measured biweekly. Efficacy was
assessed with the Positive and Negative Syndrome Scale (PANSS)
and the Nurses' Observation Scale for Inpatient Evaluation
(NOSIE). For determining the impacts of possible prognostic
factors on body weight, we utilized generalized estimating
equation methods to control for other variables and the
within-subject dependence over repeated assessments.
Results: After the effects of other factors
(including baseline body weight) were adjusted, every 1-week
increase in treatment duration raised body weight by 0.442 kg (p
< .0001). Increasing baseline body weight by 1 kg reduced
weight gain by 0.022 kg (p < .0001). Every 1-year increment in
age decreased body weight by 0.052 kg (p < .001).
Undifferentiated subtype predicted higher weight by around 0.9 kg
than other subtypes (p < .05). Each 1-mg/day increment in
risperidone dosage heightened body weight by 0.084 kg (p = .015).
Responders (those with PANSS total-score reduction >= 20%)
also had higher weight by 0.513 kg on average (p = .007).
Specifically, every 1-point diminution in score in PANSS total,
PANSS positive, PANSS negative, PANSS cognitive, and NOSIE
increased body weight, on average, by 0.029 kg, 0.057 kg, 0.079
kg, 0.079 kg, and 0.035 kg, respectively (p <= .009). Other
variables did not have significant influences.
Conclusion: The results suggest that lower
initial body weight, younger age, undifferentiated subtype,
higher dosage, and treatment response (for positive, negative,
and cognitive symptoms and social functioning) are associated
with greater weight gain in acutely ill patients treated with
risperidone. Further studies with longer observation and in other
populations are needed.