Increased Appetite Plays a Key Role in Olanzapine-Induced Weight Gain in First-Episode Schizophrenia Patients

Jing Huang, Gang-Rui Hei, Ye Yang, Chen-Chen Liu, Jing-Mei Xiao, Yu-Jun Long, Xing-Jie Peng, Yi Yang, Jing-Ping Zhao, Ren-Rong Wu, Jing Huang, Gang-Rui Hei, Ye Yang, Chen-Chen Liu, Jing-Mei Xiao, Yu-Jun Long, Xing-Jie Peng, Yi Yang, Jing-Ping Zhao, Ren-Rong Wu

Abstract

Weight gain and metabolic disturbances, potentially influenced by increased appetite, are common effects of olanzapine treatment in patients with schizophrenia. In this study, we explored the association between olanzapine-induced weight gain and metabolic effects with increased appetite. Drug-naïve, first-episode schizophrenia patients were treated with olanzapine for 12 weeks. Assessments included time to increased appetite, body weight, body mass index, biochemical indicators of blood glucose and lipids, proportion of patients who gained more than 7% or 10% of their baseline weight upon treatment conclusion, patients who developed dyslipidemia, and Positive and Negative Syndrome Scale scores. In total, 33 patients with schizophrenia receiving olanzapine were enrolled and 31 completed the study. During the 12-week olanzapine treatment, 77.4% (24/31) patients had increased appetite with 58.1% (18/31) patients having increased appetite within the first 4 weeks. The mean time for increased appetite was 20.3 days. More patients in the increased appetite group increased their initial body weight by more than 7% after 12 weeks when compared to patients with unchanged appetite (22/24 [91.7%] vs. 3/7 [42.9%], p = 0.004). Earlier increased appetite led to more weight gain during the following month. Overall, 50% of patients in the increased appetite group had dyslipidemia after 12 weeks. Our results demonstrated that olanzapine induced significantly appetite increase in first-episode patients with schizophrenia and appetite increase played a key role in olanzapine-induced weight gain and dyslipidemia.

Clinical trial registration: NCT03451734. Registered March 2, 2018 (retrospectively registered).

Keywords: antipsychotic drugs; appetite; olanzapine; schizophrenia; weight gain.

Copyright © 2020 Huang, Hei, Yang, Liu, Xiao, Long, Peng, Yang, Zhao and Wu.

Figures

Figure 1
Figure 1
Number of patients with increased appetite during 8-week olanzapine treatment periods.
Figure 2
Figure 2
Comparison of body weight, BMI, glucose, and lipid levels between increased and unchanged appetite groups. Blue line indicates patients with increased appetite; red line indicates patients with unchanged appetite.
Figure 3
Figure 3
Mean weight gain velocity in increased appetite group. The mean weight gain for each patient per month during the study period was analyzed at four time points: before the month of time to increased appetite (−1M), the month of time to increased appetite (0M), 1 month after the month of time to increased appetite increase (+1M), and 2 months after the month of time to increased appetite (+2M). ** indicates P

Figure 4

Comparison of weight gain velocity…

Figure 4

Comparison of weight gain velocity of participants with increased appetite in different months.…

Figure 4
Comparison of weight gain velocity of participants with increased appetite in different months. We compared the weight gain velocity of participants with increased appetite within 4 weeks (A) and participants with an increased appetite between 4 and 8 weeks (B) in the month of time to increased appetite (0M) and 1 month after the month of time to increased appetite (+1M). ns, indicates not significant, * indicates P
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Figure 4
Figure 4
Comparison of weight gain velocity of participants with increased appetite in different months. We compared the weight gain velocity of participants with increased appetite within 4 weeks (A) and participants with an increased appetite between 4 and 8 weeks (B) in the month of time to increased appetite (0M) and 1 month after the month of time to increased appetite (+1M). ns, indicates not significant, * indicates P

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