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The effects of antipsychotics on weight gain, weight-related hormones and homocysteine in children and adolescents: a 1-year follow-up study

European Child & Adolescent Psychiatry volume 26, pages 35–46 (2017)Cite this article

Abstract

To analyze weight gain, metabolic hormones, and homocysteine (Hcys) levels in children and adolescents on antipsychotics (AP) during a year-long follow-up. 117 patients, AP-naïve or quasi-naïve (less than 30 days on AP), were included. Weight, body mass index (BMI), BMI z-score (z-BMI), and levels of leptin, insulin, insulin resistance (HOMA-IR), adiponectin, ghrelin, thyroid stimulating hormone (TSH), free thyroxine (FT4), and Hcys were measured at baseline, and at 3, 6, and 12 months, while patients remained on the same AP. Patients (mean age: 14.4 ± 3 years; 64.1 % male) were on risperidone (N = 84), olanzapine (N = 20) or quetiapine (N = 13) from baseline up to 1-year follow-up and significantly increased weight (5.8 ± 4.3 kg at 3-month, 8.1 ± 6.1 kg at 6-month, and 11.6 ± 7.0 kg at 1 year), BMI, and z-BMI. Leptin levels significantly increased from baseline to 3 and 6 months, as did TSH levels from baseline to 3 months, while FT4 levels decreased from baseline to 3 and 6 months. Patients with BMI >85th percentile at baseline (N = 16) significantly increased weight, BMI, and z-BMI, more than patients with normal BMI over time. Higher baseline levels of insulin, HOMA-IR, and leptin were associated with increased weight/BMI during follow-up, while higher baseline levels of FT4, adiponectin, and ghrelin were associated with lower weight/BMI during follow-up. All AP were associated with increased weight and BMI/z-BMI in all of the assessments; however, at 1-year assessment, this increase was significantly higher for patients on quetiapine. Both higher baseline levels of insulin, HOMA-IR, and leptin, as well as being overweight/obese at baseline were associated with increased weight/BMI during 1-year follow-up in children and adolescents on AP. Awareness of weight-related parameters in this population may help inform decisions regarding AP prescriptions.

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Acknowledgments

We would like to thank the Center for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid (Spain); for partial funding, the following: the Spanish Ministry of Health, Instituto de Salud Carlos III ≪Health Research Fund≫ (F.I.S.-PI04/0455); Madrid Mental Health Association (≪Miguel Angel Martín≫ Research Grant); ≪NARSAD 2005: Independent Investigator Award≫; Alicia Koplowitz and Mutua Madrileña foundations; and the Ministries of Science and Innovation, Community of Madrid, Biomedical R&D funding S2010/BMD-2422 AGES (Madrid) for their support. FP7-HEALTH-F4-2010-241959 (Project PERS—Pediatric European Risperidone Studies). The authors thank Mr. A.D.Pierce for his English editorial assistance.

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Affiliations

  1. Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Institut Clinic of Neurosciences, IDIBAPS (Institut d’Investigacions Biomèdiques August Pi Sunyer), Hospital Clínic Universitari of Barcelona, Villarroel, 170, Barcelona, 08036, Spain

    Inmaculada Baeza, Elena de la Serna, Rosa Calvo-Escalona & Josefina Castro-Fornieles

  2. Department of Psychiatry and Psychobiology, University of Barcelona, Barcelona, Spain

    Josefina Castro-Fornieles

  3. Adolescent Service, Mapther house, Maudsley Hospital, London, UK

    Laura Vigo

  4. Child and adolescent Psychiatry Department, School of Medicine, Hospital General Universitario Gregorio Marañón, Universidad Complutense, IISGM, CIBERSAM, Madrid, Spain

    Jessica Merchán-Naranjo, Pamela Rodríguez-Latorre & Celso Arango

  5. Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain

    Inmaculada Baeza, Elena de la Serna, Rosa Calvo-Escalona & Josefina Castro-Fornieles

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  1. Inmaculada Baeza
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  2. Laura Vigo
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  3. Elena de la Serna
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  4. Rosa Calvo-Escalona
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  5. Jessica Merchán-Naranjo
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  8. Josefina Castro-Fornieles
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Correspondence to Inmaculada Baeza.

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Conflict of interest

IB has received honoraria and travel support from Otsuka and Janssen, research support from Fundación Alicia Koplowitz and grants from the Spanish Ministry of Health, Instituto de Salud Carlos III. RCE has a grant from the Spanish Ministry of Health, Instituto de Salud Carlos III, and has received travel support from Shire. CA is a consultant for AstraZeneca, Bristol Myers Squibb, Janssen-Cilag, Pfizer and Servier; has received grants/support from the Spanish Ministry of Health, Instituto de Salud Carlos III, the European Comission, Fundación Alicia Koplowitz, Astra-Zeneca, Bristol Myers Squibb. JCF has been a consultant for Eli Lilly and has received grants from the Spanish Ministry of Health, Instituto de Salud Carlos III, the European Comission and Fundació La Marató de TV3. LV, ES, JMN and PRL declare no conflicts of interest.

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Baeza, I., Vigo, L., de la Serna, E. et al. The effects of antipsychotics on weight gain, weight-related hormones and homocysteine in children and adolescents: a 1-year follow-up study. Eur Child Adolesc Psychiatry 26, 35–46 (2017). https://doi.org/10.1007/s00787-016-0866-x

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Keywords

  • Antipsychotic
  • Side effects
  • Weight gain
  • Children
  • Adolescents