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European Journal of Clinical Pharmacology

, Volume 74, Issue 11, pp 1485–1489 | Cite as

Weight changes associated with antiepileptic mood stabilizers in the treatment of bipolar disorder

  • Koen P. Grootens
  • Anna Meijer
  • Erwin G. Hartong
  • Bennard Doornbos
  • P. Roberto Bakker
  • Asmar Al Hadithy
  • Kirsten N. Hoogerheide
  • Frans Overmeire
  • Radboud M. Marijnissen
  • Henricus G. Ruhe
Pharmacoepidemiology and Prescription

Abstract

Objective

To present up-to-date information and recommendations on the management of body weight changes during the use of antiepileptic mood stabilizers in bipolar disorder to help clinicians and patients make well-informed, practical decisions.

Data sources

Umbrella review. Systematic reviews and meta-analyses on the prevention, treatment, and monitoring of body weight changes as a side effect of the mood stabilizers valproate, lamotrigine, topiramate, and carbamazepine were identified in Embase (2010–2015, no language restrictions).

Study selection

The search yielded 18 relevant publications on antiepileptic mood stabilizers and weight changes in bipolar disorder.

Data extraction

Relevant scientific evidence was abstracted and put into a clinical perspective by a multidisciplinary expert panel of clinicians with expertise in the treatment of bipolar disorders across all age groups and a patient representative.

Results

Valproate has been proven to be associated with weight gain in up to 50% of its users, and can be detected 2–3 months after initiation. Carbamazepine has been proven to have a low risk of weight gain. Lamotrigine and topiramate are associated with weight loss. Other option for this sentence = Weigth gain has been proven to be associated with valproate use in up to 50% of its users, and can be detected within 2-3 months after initiation.

Conclusion

Each antiepileptic mood stabilizer has specific effects on body weight and accordingly requires a discrete education, prevention, monitoring, and treatment strategy. Clinicians are recommended to adopt an active, anticipatory approach, educating patients about weight change as an important side effect in order to come to informed shared decisions about the most suitable mood stabilizer.

Keywords

Bipolar disorder Weight gain Weight loss Anti-obesity agents Body weight changes Valproate Lamotrigine Topiramate Carbamazepine 

Notes

Funding

This study was funded by the Dutch network for quality development in mental health (Netwerk Kwaliteitsontwikkeling GGZ).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Supplementary material

228_2018_2517_MOESM1_ESM.docx (23 kb)
Table 1 (DOCX 22 kb)
228_2018_2517_MOESM2_ESM.docx (56 kb)
Figure 1 (DOCX 56 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018
corrected publication September/2018

Authors and Affiliations

  • Koen P. Grootens
    • 1
    • 2
  • Anna Meijer
    • 3
    • 4
  • Erwin G. Hartong
    • 5
  • Bennard Doornbos
    • 6
  • P. Roberto Bakker
    • 7
    • 8
  • Asmar Al Hadithy
    • 9
  • Kirsten N. Hoogerheide
    • 10
  • Frans Overmeire
    • 12
  • Radboud M. Marijnissen
    • 4
    • 11
  • Henricus G. Ruhe
    • 2
    • 4
  1. 1.Reinier van Arkel‘s-HertogenboschThe Netherlands
  2. 2.Radboud University Medical CentreNijmegenThe Netherlands
  3. 3.Department of Teacher Education, Faculty of Behavioural and Social SciencesUniversity of GroningenGroningenThe Netherlands
  4. 4.University Medical Centre GroningenGroningenThe Netherlands
  5. 5.Department of PsychiatryCanisius Wilhelmina Hospital NijmegenNijmegenThe Netherlands
  6. 6.GGZ DrentheAssenThe Netherlands
  7. 7.GGZ CentraalAmersfoortThe Netherlands
  8. 8.Maastricht UniversityMaastrichtThe Netherlands
  9. 9.Parnassia GroupThe HagueThe Netherlands
  10. 10.De JuttersThe HagueThe Netherlands
  11. 11.Pro PersonaWolfhezeThe Netherlands
  12. 12.VMDB (Dutch association of patients with bipolar disorder and their relatives)AmersfoortNetherlands

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