TY - JOUR
T1 - Phenotypic factors associated with amisulpride-induced weight gain in first-episode psychosis patients (from the OPTiMiSE cohort)
AU - Pandit, R.
AU - Cianci, D.
AU - ter Hark, S. E.
AU - Winter-van Rossum, I.
AU - Ebdrup, B. H.
AU - Broberg, B. V.
AU - Garcia-Portilla, M. P.
AU - Bobes, J.
AU - Vinkers, C. H.
AU - Kahn, R. S.
AU - Guloksuz, S.
AU - Huitema, A. D. R.
AU - Luykx, J. J.
N1 - This article is protected by copyright. All rights reserved.
PY - 2019
Y1 - 2019
N2 - Objective: Antipsychotic-induced weight gain (AiWG) is a debilitating adverse effect of most antipsychotics. First-episode psychosis patients are particularly vulnerable to the detrimental consequences of AiWG. Amisulpride has good efficacy and tolerability. We here aimed to identify the phenotypic factors associated with amisulpride-induced weight gain in first-episode psychosis patients. Method: Data were collected from the Optimization of Treatment and Management of Schizophrenia in Europe trial. Multivariable regression models with various phenotypic variables (N = 305) were performed with absolute AiWG and clinically relevant AiWG (≥7% AiWG) as outcomes. Results: Four weeks of amisulpride treatment increased body weight from 69.7 to 72.4 kg (P < 0.001). In the regression model of absolute AiWG, unemployment (β = 0.94, P = 0.016), younger age (β = −0.07, P = 0.031) and absence of current comorbid major depression disorder (β = −1.61, P = 0.034) were positively associated with absolute AiWG. In the regression model of clinically relevant AiWG, unemployment (OR = 2.83, P = 0.001), schizophreniform disorder (OR = 2.00, P = 0.025) and low baseline weight (OR = 0.97, P = 0.032) increased the likelihood of clinically relevant AiWG. Conclusions: Clinicians prescribing amisulpride should consider the relatively high susceptibility to AiWG in unemployed first-episode patients with psychosis, in particular young subjects with a diagnosis of schizophreniform disorder. We advise to carefully monitor these patients and, when needed, implement weight-reducing strategies.
AB - Objective: Antipsychotic-induced weight gain (AiWG) is a debilitating adverse effect of most antipsychotics. First-episode psychosis patients are particularly vulnerable to the detrimental consequences of AiWG. Amisulpride has good efficacy and tolerability. We here aimed to identify the phenotypic factors associated with amisulpride-induced weight gain in first-episode psychosis patients. Method: Data were collected from the Optimization of Treatment and Management of Schizophrenia in Europe trial. Multivariable regression models with various phenotypic variables (N = 305) were performed with absolute AiWG and clinically relevant AiWG (≥7% AiWG) as outcomes. Results: Four weeks of amisulpride treatment increased body weight from 69.7 to 72.4 kg (P < 0.001). In the regression model of absolute AiWG, unemployment (β = 0.94, P = 0.016), younger age (β = −0.07, P = 0.031) and absence of current comorbid major depression disorder (β = −1.61, P = 0.034) were positively associated with absolute AiWG. In the regression model of clinically relevant AiWG, unemployment (OR = 2.83, P = 0.001), schizophreniform disorder (OR = 2.00, P = 0.025) and low baseline weight (OR = 0.97, P = 0.032) increased the likelihood of clinically relevant AiWG. Conclusions: Clinicians prescribing amisulpride should consider the relatively high susceptibility to AiWG in unemployed first-episode patients with psychosis, in particular young subjects with a diagnosis of schizophreniform disorder. We advise to carefully monitor these patients and, when needed, implement weight-reducing strategies.
KW - amisulpride
KW - antipsychotic
KW - psychosis
KW - schizophrenia
KW - weight gain
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85070432748&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31323113
U2 - https://doi.org/10.1111/acps.13074
DO - https://doi.org/10.1111/acps.13074
M3 - Article
C2 - 31323113
SN - 1600-0447
VL - 140
SP - 283
EP - 290
JO - Acta psychiatrica Scandinavica
JF - Acta psychiatrica Scandinavica
IS - 3
ER -