• DOI:10.4088/JCP.V65N1102
• Corpus ID: 12508111

Metabolic effects of treatment with atypical antipsychotics.

@article{Kane2004MetabolicEO,
  title={Metabolic effects of treatment with atypical antipsychotics.},
  author={John M. Kane and Eugene J. Barrett and Daniel E. Casey and Christoph U. Correll and Alan J. Gelenberg and Samuel Klein and John W. Newcomer},
  journal={The Journal of clinical psychiatry},
  year={2004},
  volume={65 11},
  pages={
          1447-55
        }
}

• J. Kane, E. Barrett, +4 authors J. Newcomer
• Published 1 November 2004
• Medicine, Psychology
• The Journal of clinical psychiatry

NR 391:145–146] projected a mean drop in weight of 21.6 lb over 58 weeks in patients switching from olanzapine to ziprasidone. That exceeds 5% of their average baseline body weight, which begs the question about whether it is better to focus on intensive dietary programs or on switching medications. Dr. Kane: Or—as someone suggested earlier— avoiding those risks up front, in terms of prevention. Dr. Barrett: Having head-to-head trial data with clinically effective doses for treating psychosis will be helpful in showing weight gain and lipid changes that occur when switching medications. Then we would be on surer ground for making a recommendation. Dr. Correll: Coming back to the ADA guidelines, a 5% body weight increase is the time point when clinicians should consider switching patients’ medications, particularly if there is early weight gain, because the available data suggest that early weight gain predicts later weight gain. If a patient gains a lot of weight quickly, that agent is not a good fit for that patient. Dr. Gelenberg: The ADA consensus emphasized this. Physicians need to work toward an overall balance. There may be times when the cardiovascular and metabolic risks are outweighed by the fact that a certain agent may be the main thing that keeps the patient alive, functioning, and free of psychosis. In that case, in a logical algorithm with appropriate consent, then the decision has to be for the lesser evil. Drug names: aripiprazole (Abilify), chlorpromazine (Thorazine, Sonazine, and others), clozapine (Clozaril, Fazaclo, and others), divalproex sodium (Depakote), fluphenazine (Prolixin and others), haloperidol (Haldol and others), lithium (Eskalith, Lithobid, and others), molindone (Moban), olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal), valproate (Depacon and others), ziprasidone (Geodon). Disclosure of off-label usage: The chair has determined that, to the best of his knowledge, no investigational information about pharmaceutical agents has been presented in this article that is outside U.S. Food and Drug Administration–approved labeling. Affiliations: From the Department of Psychiatry (Dr. Kane) and the Department of Psychiatry Research (Dr. Correll), The Zucker Hillside Hospital, Glen Oaks, N.Y.; the Department of Internal Medicine and Endocrinology, the University of Virginia, Charlottesville (Dr. Barrett); the Department of Psychiatry, Oregon Health and Science University, Portland (Dr. Casey); the Department of Psychiatry, Arizona Health Science Center, Tucson (Dr. Gelenberg); and the Department of Internal Medicine, Nutritional Science Section (Dr. Klein) and the Department of Psychiatry (Dr. Newcomer), Washington University School of Medicine, St. Louis, Mo. Financial disclosure: In the spirit of full disclosure and in compliance with all ACCME Essential Areas and Policies, the faculty for this CME activity were asked to complete a full disclosure statement. The information received is as follows: Dr. Kane is a consultant for Abbott, Pfizer, Johnson & Johnson, Eli Lilly, and Janssen and is a member of the speakers/advisory board for Bristol-Myers Squibb,