ANTIPSYCHOTIC TREATMENT AND WEIGHT GAIN: DOES RISPERIDONE BEHAVE DIFFERENTLY IN PAKISTANI PSYCHIATRIC PATIENTS?

Saleem Perwaiz Iqbal, Rashid AM Khan, Syed Ahmer

Abstract


Background: Studies from the Western world have shown that antipsychotic medications in
psychiatric patients result in weight gain and other metabolic diseases. This study was undertaken to
investigate whether any one of the five most commonly prescribed antipsychotics, (risperidone,
olanzepine, trifluoperazine, quetiapine and haloperidol) could behave differently in terms of causing
weight gain among patients attending the psychiatric outpatient clinics in a tertiary care hospital in
Karachi, Pakistan. Methods: For this retrospective cohort study, data were collected from outpatient
records of the Aga Khan University Hospital, from 2003 to 2007. Demographic and clinical data were
analysed. Repeated measures ANOVA, using a linear mixed model approach was used to assess weight
gain over time due to the use of antipsychotic medications. Results: A total of 124 subject records (68
males and 56 females) were evaluated. One-way ANOVA revealed that the groups being prescribed
with antipsychotics were comparable with respect to age, duration of treatment and weight
measurements. Frequencies were calculated which showed that weight increases significantly over time
with respect to the prescribed antipsychotic medications, except for risperidone. Repeated measures
ANOVA using the linear mixed model approach showed that the serial weight measurements were
significantly different across the follow up times (p<0.05). Conclusion: Four of the commonly
prescribed antipsychotic drugs do result in an increase in weight; however risperidone has no such
effect, making it an option in treating psychiatric disorders without worrying for any gain in weight. In
view of the increased prevalence of obesity and other metabolic diseases, measures should be taken
towards careful prescription of antipsychotic medications.
Keywords: Schizophrenia depression weight gain obesity antipsychotics risperidone

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