한국인 정신분열병 환자에서 비정형 항정신병 약물의 치료반응과 체중증가의 관련성에 대한 연구
Association between the Weight Gain and Treatment Response to Atypical Antipsychotics in Korean Patients with Schizophrenia
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Objectives :Atypical antipsychotics show better treatment efficacy, safety and tolerability than typical antipsychotics. Among the adverse events observed during treatment with antipsychotics, extrapyramidal syndrome (EPS) and negative symptoms has been greatly reduced. But still, weight gain is receiving growing attention. The aim of this study was to investigate the association between therapeutic response to atypical antipsychotics and weight gain in admission status. Methods : The study was conducted for Korean inpatients with schizophrenia in a university hospital in Seoul, between Jan 2006 and Dec 2010. Data was collected by reviewing the medical record of 39 consecutively hospitalized patients with Schizophrenia (DSM-IV) at a university hospital. Positive and Negative Symptom Scale (PANSS), Body Mass Index (BMI) and body weights were measured. Results : No significant difference was observed for sex, age, illness onset age, family history of schizophrenia, numbers of hospitalization before treatment, educational years, marriage status, occupational status and subtype of schizophrenia between weight gainers and non-weight gainers. Regarding treatment response to atypical antipsychotics, weight gainers show significantly more PANSS decrease than non-weight gainers during admission period. Conclusions : Our findings suggest that it appears to be more likely to respond to atypical antipsychotics in weight gainers than non-weight gainers (that weght gainers appear to be more likely to respond to atypical antipsychotics than non-weight gainers). These results show that the antipsychotic- induced body weight gain is associated with therapeutic response of antipsychotics in Korean inpatients with schizophrenia.
Abstract
Objectives :Atypical antipsychotics show better treatment efficacy, safety and tolerability than typical antipsychotics. Among the adverse events observed during treatment with antipsychotics, extrapyramidal syndrome (EPS) and negative symptoms has been greatly reduced. But still, weight gain is receiving growing attention. The aim of this study was to investigate the association between therapeutic response to atypical antipsychotics and weight gain in admission status. Methods : The study was conducted for Korean inpatients with schizophrenia in a university hospital in Seoul, between Jan 2006 and Dec 2010. Data was collected by reviewing the medical record of 39 consecutively hospitalized patients with Schizophrenia (DSM-IV) at a university hospital. Positive and Negative Symptom Scale (PANSS), Body Mass Index (BMI) and body weights were measured. Results : No significant difference was observed for sex, age, illness onset age, family history of schizophrenia, numbers of hospitalization before treatment, educational years, marriage status, occupational status and subtype of schizophrenia between weight gainers and non-weight gainers. Regarding treatment response to atypical antipsychotics, weight gainers show significantly more PANSS decrease than non-weight gainers during admission period. Conclusions : Our findings suggest that it appears to be more likely to respond to atypical antipsychotics in weight gainers than non-weight gainers (that weght gainers appear to be more likely to respond to atypical antipsychotics than non-weight gainers). These results show that the antipsychotic- induced body weight gain is associated with therapeutic response of antipsychotics in Korean inpatients with schizophrenia.
참고문헌 (36)
- David SR, "The effects of olanzapine, risperidone, and haloperidol on plasma prolactin levels in patients with schizophrenia", Clin Ther, 22, pp.1085~1096 (2000)
- Tollefson GD, "Olanzapine versus haloperidol in the treatment of schizophrenia and schizoaffective and schizophreniform disorders: results of an international collaborative trial", Am J Psychiatry, 154, pp.457~465 (1997)
- Rege S, "Antipsychotic induced weight gain in schizophrenia: mechanisms and management", Aust N Z J Psychiatry, 42, pp.369~381 (2008)
- Casey DE, "The relationship of pharmacology to side effects", J Clin Psychiatry, 58(10), pp.55~62 (1997)
- Allison DB, "Antipsychotic-induced weight gain: a comprehensive research synthesis", Am J Psychiatry, 156, pp.1686~1696 (1999)
- Ganguli R, "Weight gain associated with antipsychotic drugs", J Clin Psychiatry, 60(21), pp.20~24 (1999)
- Lieberman JA, "Effectiveness of antipsychotic drugs in patients with chronic schizophrenia", N Engl J Med, 353, pp.1209~1223 (2005)
- Weiden PJ, "Obesity as a risk factor for antipsychotic noncompliance", Schizophr Res, 66, pp.51~57 (2004)
- Theisen FM, "Prevalence of obesity in adolescent and young adult patients with and without schizophrenia and in relationship to antipsychotic medication", J Psychiatr Res, 35, pp.339~345 (2001)
- Brixner DI, "Naturalistic impact of second-generation antipsychotics on weight gain", Ann Pharmacother, 40, pp.626~632 (2006)
- Czobor P, "Antipsychotic-induced weight gain and therapeutic response: a differential association", J Clin Psychopharmacol, 22, pp.244~251 (2002)
- Ascher-Svanum H, "Acute weight gain, gender, and therapeutic response to antipsychotics in the treatment of patients with schizophrenia", BMC Psychiatry, 5, pp.3~ (2005)
- Garyfallos G, "Olanzapine versus risperidone: weight gain and elevation of serum triglyceride levels", Eur Psychiatry, 18, pp.320~321 (2003)
- American Diabetes Association, "Consensus development conference on antipsychotic drugs and obesity and diabetes", Diabetes Care, 27, pp.596~601 (2004)
- Kay SR, "The positive and negative syndrome scale (PANSS) for schizophrenia", Schizophr Bull, 13, pp.261~276 (1987)
- Woods SW, "Chlorpromazine equivalent doses for the newer atypical antipsychotics", J Clin Psychiatry, 64, pp.663~667 (2003)
- MÜller MJ, "Dose-related effects of amisulpride on five dimensions of psychopathology in patients with acute exacerbation of schizophrenia", J Clin Psychopharmacol, 22, pp.554~560 (2002)
- Simpson GM, "Double-blind study of clozapine dose response in chronic schizophrenia", Am J Psychiatry, 156, pp.1744~1750 (1999)
- Tzimos A, "Safety and tolerability of oral paliperidone extended- release tablets in elderly patients with schizophrenia: a doubleblind, placebo-controlled study with six-month open-label extension", Am J Geriatr Psychiatry, 16, pp.31~43 (2008)
- Jalenques I, "Weight gain and clozapine", Encephale, 22(3), pp.77~79 (1996)
- Wetterling T, "Weight gain: side effect of atypical neuroleptics", J Clin Psychopharmacol, 19, pp.316~321 (1999)
- Kalucy RS, "Drug-induced weight gain", Drugs, 19, pp.268~278 (1980)
- Bustillo JR, "Differential effect of clozapine on weight: a controlled study", Am J Psychiatry, 153, pp.817~819 (1996)
- Bai YM, "Weight gain among patients on clozapine", Psychiatr Serv, 50, pp.704~705 (1999)
- Shrivastava A, "Weight-gain in psychiatric treatment: risks, implications, and strategies for prevention and management", Mens Sana Monogr, 8, pp.53~68 (2010)
- Wetterling T, "Bodyweight gain with atypical antipsychotics", A comparative review, 24, pp.59~73 (2001)
- Stanton JM, "Weight gain associated with neuroleptic medication: a review", Schizophr Bull, 21, pp.463~472 (1995)
- Baptista T, "Body weight gain induced by antipsychotic drugs: mechanisms and management", Acta Psychiatr Scand, 100, pp.3~16 (1999)
- Jin H, "Impact of atypical antipsychotic therapy on leptin, ghrelin, and adiponectin", Schizophr Res, 100, pp.70~85 (2008)
- Chengappa KN, "Risperidone use at a state hospital: a clinical audit 2 years after the first wave of risperidone prescriptions", J Clin Psychiatry, 60, pp.373~378 (1999)
- Jaffe AB, "Efficacy and effectiveness of first- and secondgeneration antipsychotics in schizophrenia", J Clin Psychiatry, 64(17), pp.3~6 (2003)
- Stroup TS, "Effectiveness of olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia after discontinuing perphenazine: a CATIE study", Am J Psychiatry, 164, pp.415~427 (2007)
- Taylor M, "Comparing the use and discontinuation of antipsychotics in clinical practice: an observational study", J Clin Psychiatry, 69, pp.240~245 (2008)
- Essock SM, "Clozapine's effectiveness for patients in state hospitals: results from a randomized trial", Psychopharmacol Bull, 32, pp.683~697 (1996)
- Wirshing DA, "Novel antipsychotics: comparison of weight gain liabilities", J Clin Psychiatry, 60, pp.358~363 (1999)
- Marder SR, "The Mount Sinai conference on the pharmacotherapy of schizophrenia", Schizophr Bull, 28, pp.5~16 (2002)
