RESUMEN
OBJECTIVE: The purpose of this study is to give a systematic review of change of weight associated with commonly used psychotropic drugs. METHODS: Mainly based on a MEDLINE-supported review until April 2005, data from clinical studies with antidepressants, anticonvulsants, mood stabilizers and neuroleptics were scanned for change of weight during treatment. RESULTS: Among antidepressants amitryptiline and nortriptyline have the highest incidence of weight gain followed by imipramine. Maprotiline and mirtazapine have an intermediate weight increasing potential. SSRI (except paroxetine) and MAOI had no or only slight weight inducing effects. In contrary, bupropion was associated with weight reduction. Regarding mood stabilizers and anticonvulsants, a marked gain in weight with lithium and sodium valproate was reported frequently. With gabapentin and vigabatrin a slight to moderate gain in weight was found. Minor changes of weight were found with carbamazepine and lamotrigine. Treatment with topiramate and felbamate reportedly lead to weight loss. The atypical neuroleptics clozapine and olanzapine were frequently related to a strong gain in weight followed by risperidone. Quetiapine has intermediate effects. Stable weight was found with aripiprazole and ziprasidone. A gain in weight is less frequent with older/typical neuroleptics. CONCLUSION: Beside some methodological restrictions like inconsistent information of weight changes (e. g. percent vs. mass) and the small sample of available long term studies, this review specifies the incidence of weight changes for commonly used psychotropic drugs and might be helpful to look for alternatives.
Asunto(s)
Psicotrópicos/efectos adversos , Aumento de Peso/efectos de los fármacos , Animales , Anticonvulsivantes/efectos adversos , Antidepresivos Tricíclicos/efectos adversos , Antipsicóticos/efectos adversos , Humanos , Psicotrópicos/uso terapéutico , Inhibidores Selectivos de la Recaptación de Serotonina/efectos adversosAsunto(s)
Antipsicóticos/uso terapéutico , Ansiedad/tratamiento farmacológico , Trastorno Bipolar/tratamiento farmacológico , Dibenzotiazepinas/uso terapéutico , Trastornos Fóbicos/tratamiento farmacológico , Adulto , Ansiedad/epidemiología , Trastorno Bipolar/epidemiología , Comorbilidad , Femenino , Humanos , Trastornos Fóbicos/epidemiología , Fumarato de Quetiapina , Resultado del TratamientoRESUMEN
The Stanley Foundation Bipolar Network (SFBN) is an international, multisite network investigating the characteristics and course of bipolar disorder. Methods (history, ratings and longitudinal follow-up) are standardized and equally applied in all 7 centres. This article describes demographics and illness characteristics of the first 152 German patients enrolled in the SFBN as well as the results of 2.5 years of follow-up. Patients in Germany were usually enrolled after hospitalisation. More than 72% of the study population suffered from bipolar I disorder and 25% from bipolar II disorder. The mean +/- SD age of the study participants was 42.08 +/- 13.5 years, and the mean +/- SD age of onset 24.44 +/- 10.9 years. More than 40% of the sample reported a rapid-cycling course in history, and even more a cycle acceleration over time. 37% attempted suicide at least once. 36% had an additional Axis I disorder, with alcohol abuse being the most common one, followed by anxiety disorders. During the follow-up period, only 27% remained stable, 56% had a recurrence, 12.8% perceived subsyndromal symptoms despite treatment and regular visits. 27% suffered from a rapid-cycling course during the follow-up period. Recurrences were significantly associated with bipolar I disorder, an additional comorbid Axis I disorder, rapid cycling in history, a higher number of mood stabilizers and the long-term use of typical antipsychotics. Rapid cycling during follow-up was only associated with a rapid-cycling course in history, a higher number of mood stabilizers and at least one suicide attempt in history.