Risk factors and pattern of weight gain in youths using antipsychotic drugs
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ORIGINAL CONTRIBUTION
Risk factors and pattern of weight gain in youths using antipsychotic drugs Casper C. L. van der Esch1,2 · Sanne M. Kloosterboer1,2 · Jan van der Ende2 · Catrien G. Reichart3 · Mirjam E. J. Kouijzer4 · Matthias M. J. de Kroon5 · Emma van Daalen6 · Wietske A. Ester3,7,8 · Rob Rieken9 · Gwen C. Dieleman2 · Manon H. J. Hillegers2 · Teun van Gelder1 · Birgit C. P. Koch1 · Bram Dierckx2 Received: 21 October 2019 / Accepted: 1 August 2020 © The Author(s) 2020
Abstract Antipsychotic-induced weight gain is a major health concern in children and adolescents. The aim of this study was to identify risk factors for weight gain during short-, middle- and long-term treatment with antipsychotic drugs in this young population. We analysed a combined prospective and a retrospective observational cohort of Dutch children and adolescents, starting with risperidone, aripiprazole or pipamperone treatment. Linear mixed models were used to test whether sex, age, baseline body-mass-index (BMI) z score, type of antipsychotic, dose equivalent/kg, duration of use, previous antipsychotic use, ethnicity, physical exercise, IQ, concomitant medication, and psychiatric classification predicted the BMI z score for a follow-up of 52 weeks. A total of 144 patients were included with a median [interquartile range ([IQR)] age of 9 (4) years and median follow-up of 30 (73) weeks. During the complete follow-up, the median (IQR) weight gain was 0.37 (0.95) BMI z score points. Antipsychotic-induced weight gain was found to be most pronounced during the first 15 weeks of use (BMI z score increase per week β = 0.02, 95% CI 0.01–0.03, p = 0.002). A higher baseline BMI z score and the absence of stimulant use were associated with a higher BMI z score during the entire follow-up and after 15 weeks, respectively. Previous treatment with an antipsychotic drug was associated with less weight gain during the first 15 weeks of treatment. Our findings underscore the importance of close patient monitoring during the first weeks of antipsychotic treatment with a focus on patients with a high baseline BMI z score. Keywords Antipsychotics · Weight gain · Body mass index · Risk factors · Child · Adolescent
Introduction Antipsychotic-induced weight gain has been recognized as a major health concern in children and adolescents [1]. Although the magnitude of weight gain differs across Casper C. L. van der Esch, Sanne M. Kloosterboer contributed equally.
type of antipsychotics and individuals, on average, 1 in 7 minors gains 7% or more weight within the first 6–8 weeks of treatment [2]. This is not only highly stigmatizing, but also involves serious long-term health risks. Weight gain is associated with glucose and lipid abnormalities, thereby increasing the risk for diabetes and cardiovascular morbidity in children and adolescents using antipsychotics [3,
* Sanne M. Kloosterboer [email protected]
4
GGz Breburg, Centre of Youth, Breda, The Netherlands
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de Kroon Child Psychiatry, Breda, The Netherlands
1
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Yulius Menta
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