Strategy Slows Down Weight Gain in Youth Taking Antipsychotics
Abstract
Developing strategies that protect patients from the weight gain, lipid abnormalities, and insulin resistance associated with long-term use of antipsychotics could help improve the overall health of people after psychosis.
Though numerous studies have explored the effectiveness of interventions for antipsychotic-induced weight gain in adults after first-episode psychosis (FEP), data on interventions for children dealing with this is lacking. A group of Australian researchers may be able to help fill in the gap.
Jackie Curtis, M.D., says that psychiatrists have a responsibility to help their patients achieve “total health.” “It’s not just about mental health,” she believes.
At APA’s 2015 annual meeting in Toronto, Jackie Curtis, M.D., clinical director of Youth Mental Health at South Eastern Sydney Local Health District in Australia, premiered results from an ongoing study showing that a multidisciplinary approach may be able to help reduce antipsychotic-induced weight gain in youth.
“I’ve been working in early intervention programs since I started doing work in psychiatry 15 years ago,” said Curtis, in an interview with Psychiatric News. “I have watched young people get better as it pertains to their psychotic symptoms, but they were putting on weight—gaining anywhere from 10 to 30 kilograms.”
According to Curtis, previous research has shown that clinically significant weight gain occurs in 23 to 61 percent of FEP patients prescribed antipsychotic medications for 10 to 16 weeks, with rates increasing to an average of 80 percent after one to two years of treatment. Lipid abnormalities can emerge within the first 12 weeks of treatment and insulin resistance can occur in the first year.
Curtis said that though awareness of antipsychotic-induced weight gain is greater now than it was 15 years ago, more research is needed to understand ways to overcome this condition, particularly in young people with FEP.
Curtis and her colleagues enrolled 28 youth, aged 15 to 25, with FEP into the Keeping the Body in Mind Program (BMP), a 12-week pilot intervention program that offers weekly individualized dietetic monitoring and education and a prescription for exercise with a trainer, in addition to education in a group setting. Sixteen youth participated in BMP, while the remaining youth served as controls. Weight, blood pressure, and lipid and glucose levels were assessed.
The results showed that those enrolled in BMP had an average weight gain of 1.8 kilograms compared with 7.8 kilograms in the control group. Change in waist circumference was on average seven times greater in the control group than in the intervention group. Blood pressure, lipids, and glucose levels did not differ among the groups.
“We know that lifestyle interventions are effective, and these results show that such interventions may serve as important means of maintaining or achieving physical health in patients with psychosis,” Curtis said.
Curtis told Psychiatric News she plans to continue her research into the effectiveness of interventions for this patient population thanks in part to funding from the National Health and Medical Research Counci of Australia.
“We must consider that our patients are concerned about their physical health and make sure that we address these issues,” emphasized Curtis. “It’s a part of our job as psychiatrists. It’s not just about mental health, it’s about total health. I really feel optimistic that total health can be achieved in our patients,” she concluded. ■
