Severe weight gain as an adverse drug reaction of psychotropics: Data from the AMSP project between 2001 and 2016

摘要

Severe weight gain induced by psychotropics is a known problem in psychiatry. Various drugs from different classes may lead to weight gain that may further lead to potentially life-shortening diseases, such as diabetes or cardiovascular disease. A total of 344 cases of severe weight gain (>10% of body weight) have been documented by the drug safety in psychiatry program AMSP between 2001 and 2016. Patients gained 12.7 +/- 5.5 kg weight within 12 +/- 15 weeks. This equals a Body Mass Index (BMI) gain of 4.4 +/- 1.9 kg/m(2) to a final BMI of 28.8 +/- 5.5 kg/m(2). In addition, 142 retrospective reports documented at admission have been analyzed. Within one year these patients gained 6.4 +/- 4.0 kg/m(2) to a final BMI of 31.9 kg/m(2). The weight gain was extreme in some cases. For example, 35% of the patients gained more than 20 kg. On average the patients reached overweight or even adiposity. Only 27% of the patients could loose some weight at the end of their stay. This emphasizes the relevance of this long-term problem for the patients' health. Mostly second generation antipsychotics, and therein olanzapine, as well as antidepressants and anticonvulsants have been imputed. Severe weight gain is a slow process and it is rarely documented as adverse drug reaction under real-life conditions compared to the high percentage of patients with weight gain in clinical studies. It might often remain unnoticed due to shorter stationary treatment and changing treatment settings. (c) 2020 Elsevier B.V. and ECNP. All rights reserved.