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Open Access Highly Accessed Research article

Predictors and correlates for weight changes in patients co-treated with olanzapine and weight mitigating agents; a post-hoc analysis

Virginia L Stauffer1*, Ilya Lipkovich2, Vicki Poole Hoffmann3, Alexandra N Heinloth4, H Scott McGregor1 and Bruce J Kinon3

Author Affiliations

1 Neuroscience, Lilly USA, LLC, Indianapolis, IN 46285, USA

2 Statistics, Eli Lilly and Company, IN 46285, USA

3 Neuroscience, Eli Lilly and Company, IN 46285, USA

4 i3Statprobe, subsidiary of United Health Group, Ann Arbor, MI, USA

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BMC Psychiatry 2009, 9:12  doi:10.1186/1471-244X-9-12

Published: 28 March 2009

Abstract

Background

This study focuses on exploring the relationship between changes in appetite or eating behaviors and subsequent weight change for adult patients with schizophrenia or bipolar disorder treated with olanzapine and adjunctive potential weight mitigating pharmacotherapy. The aim is not to compare different weight mitigating agents, but to evaluate patients' characteristics and changes in their eating behaviors during treatment. Identification of patient subgroups with different degrees of susceptibility to the effect of weight mitigating agents during olanzapine treatment may aid clinicians in treatment decisions.

Methods

Data were obtained from 3 randomized, double-blind, placebo-controlled, 16-week clinical trials. Included were 158 patients with schizophrenia or bipolar disorder and a body mass index (BMI) ≥ 25 kg/m2 who had received olanzapine treatment in combination with nizatidine (n = 68), sibutramine (n = 42), or amantadine (n = 48). Individual patients were analyzed for categorical weight loss ≥ 2 kg and weight gain ≥ 1 kg. Variables that were evaluated as potential predictors of weight outcomes included baseline patient characteristics, factors of the Eating Inventory, individual items of the Eating Behavior Assessment, and the Visual Analog Scale.

Results

Predictors/correlates of weight loss ≥ 2 kg included: high baseline BMI, low baseline interest in food, and a decrease from baseline to endpoint in appetite, hunger, or cravings for carbohydrates. Reduced cognitive restraint, increase in hunger, and increased overeating were associated with a higher probability of weight gain ≥ 1 kg.

Conclusion

The association between weight gain and lack of cognitive restraint in the presence of increased appetite suggests potential benefit of psychoeducational counseling in conjunction with adjunctive pharmacotherapeutic agents in limiting weight gain during antipsychotic drug therapy.

Trial Registration

This analysis was not a clinical trial and did not involve any medical intervention.