Influence of resting energy expenditure on weight gain in adolescents taking second-generation antipsychotics

Clin Nutr. 2011 Oct;30(5):616-23. doi: 10.1016/j.clnu.2011.03.007. Epub 2011 Apr 13.

Abstract

Background & aims: Weight gain is an undesirable side effect of second-generation antipsychotics (SGAs). We performed this study to examine the influence of SGAs on resting energy expenditure (REE) and the relationship of REE to weight gain in adolescent patients.

Methods: Antipsychotic-naïve or quasi-naïve (<72 h of exposure to antipsychotics) adolescent patients taking olanzapine, quetiapine, or risperidone in monotherapy were followed up for one year. We performed a prospective study (baseline, 1, 3, 6, and 12 months after treatment) based on anthropometric measurements, bioelectrical impedance analysis, and indirect calorimetry (Deltatrac™ II MBM-200) to measure REE. We also analyzed metabolic and hormonal data and adiponectin concentrations.

Results: Forty-six out of the 54 patients that started treatment attended at least 2 visits, and 16 completed 1 year of follow-up. Patients gained 10.8 ± 6.2 kg (60% in the form of fat mass) and increased their waist circumference by 11.1 ± 5.0 cm after 1 year of treatment. The REE/kg body mass ratio decreased (p = 0.027), and the REE/percentage fat-free mass (FFM) ratio increased (p = 0.007) following the fall in the percentage of FFM during treatment. Weight increase was significantly correlated with the REE/percentage FFM ratio at all the visits (1-3-6-12 months) (r = 0.69, p = 0.004 at 12 months).

Conclusions: SGAs seem to induce a hypometabolic state (reflected as decreased REE/kg body mass and increased REE/percentage FFM). This could explain, at least in part, the changes in weight and body composition observed in these patients.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiponectin / blood
  • Adolescent
  • Adolescent Development / drug effects*
  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / therapeutic use
  • Basal Metabolism / drug effects*
  • Benzodiazepines / adverse effects
  • Benzodiazepines / therapeutic use
  • Biomarkers / blood
  • Body Composition / drug effects
  • Child
  • Cohort Studies
  • Dibenzothiazepines / adverse effects
  • Dibenzothiazepines / therapeutic use
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mental Disorders / blood
  • Mental Disorders / drug therapy*
  • Mental Disorders / metabolism*
  • Olanzapine
  • Prospective Studies
  • Quetiapine Fumarate
  • Risperidone / adverse effects
  • Risperidone / therapeutic use
  • Waist Circumference / drug effects
  • Weight Gain / drug effects*

Substances

  • ADIPOQ protein, human
  • Adiponectin
  • Antipsychotic Agents
  • Biomarkers
  • Dibenzothiazepines
  • Benzodiazepines
  • Quetiapine Fumarate
  • Risperidone
  • Olanzapine