THURSDAY, June 14, 2018 — Youth receiving antipsychotic treatment have adverse changes in adiposity and insulin sensitivity, with the greatest fat increases seen with olanzapine, according to a study published online June 13 in JAMA Psychiatry.
Ginger E. Nicol, M.D., from the Washington University School of Medicine in St. Louis, and colleagues recruited antipsychotic-naive youths aged 6 to 18 years who were diagnosed with one or more psychiatric disorders and clinically significant aggression and in whom antipsychotic treatment was considered. Participants were randomized to one of three antipsychotics commonly used in children with disruptive behavioral disorders — oral aripiprazole (49 patients), olanzapine (46 patients), or risperidone (49 patients) — and were evaluated for 12 weeks.
Overall, 29.9 percent of participants were overweight or obese at baseline. The researchers found that from baseline to week 12, the dual-energy X-ray absorptiometry percentage total body fat increased by 1.18, 4.12, and 1.66 percent for risperidone, olanzapine, and aripiprazole, respectively, and was significantly greater for olanzapine than risperidone or aripiprazole. Insulin-stimulated change in glucose rate of disappearance increased by 2.3 percent for risperidone from baseline to week 12 and decreased by 29.34 and 30.26 percent for olanzapine and aripiprazole, respectively; the difference across medications was not significant. In the pooled study sample, there was a significant decrease in the primary measure of insulin sensitivity during 12 weeks.
“The results inform risk-benefit considerations for antipsychotic use in youths,” the authors write.
Two authors disclosed financial ties to the pharmaceutical industry.
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Posted: June 2018