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Attenuating effect of reboxetine on appetite and weight gain in olanzapine-treated schizophrenia patients: a double-blind placebo-controlled study

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Abstract

Rationale

Search for safe and effective strategies to diminish weight gain associated with second generation antipsychotics (SGAs) is imperative. In the present study, we sought to replicate our preliminary findings, which indicated that coadministration of the selective norepinephrine reuptake inhibitor reboxetine attenuates olanzapine-induced weight gain.

Materials and method

Fifty-nine patients hospitalized for first-episode DSM-IV schizophrenic disorder participated in this randomized double-blind study. Reboxetine (4 mg/day; 31 patients) or placebo (29 patients) was coadministered with olanzapine (10 mg/day) for 6 weeks. Analysis was by intention-to-treat.

Results

Nine patients in each group prematurely discontinued the trial. Olanzapine/reboxetine-treated patients showed a significantly lower increase in body weight (mean = 3.31 kg, SD = 2.73) than their olanzapine/placebo-treated counterparts (mean = 4.91 kg, SD = 2.45). Significantly fewer olanzapine/reboxetine-treated patients gained at least 7% of their initial weight, the cutoff for clinically significant weight gain (6 [19.4%] of 31 patients vs 13 [46.4%] of 28 patients). Seven (22.6%) olanzapine/reboxetine-treated patients compared to only one patient (3.6%) in the olanzapine/placebo group revealed no weight change or even modest weight loss. Appetite increase was significantly lower in the olanzapine/reboxetine than olanzapine/placebo group and was correlated with attenuation of weight gain. Reboxetine addition was safe and well tolerated.

Conclusions

The results confirm that coadministration of reboxetine promotes a clinically meaningful attenuation of olanzapine-induced weight gain in schizophrenia patients. If substantiated in long-term studies, along with behavioral management and diet counseling, reboxetine may have a clinical utility in controlling SGA-induced weight gain.

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Acknowledgments

The study was supported in part by grant no. 03T-294 from the Stanley Medical Research Institute. The authors thank Rena Kurs for assistance in preparation of the manuscript.

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Author notes

  1. Camil Fuchs

    Present address: Department of Statistics, University of Pittsburgh, Pittsburgh, PA, USA

Authors and Affiliations

  1. Research Unit, Tirat Carmel Mental Health Center, P.O. Box 9, Tirat Carmel, 30200, Israel

    Michael Poyurovsky, Artashez Pashinian, Aya Levi & Sarit Faragian

  2. Rappaport Faculty of Medicine, Israel Institute of Technology—Technion, Haifa, Israel

    Michael Poyurovsky

  3. Department of Statistics and Operations Research, Tel-Aviv University, Tel-Aviv, Israel

    Camil Fuchs

  4. Laboratory of Biological Psychiatry, Felsenstein Medical Research Center, Geha Psychiatric Hospital, Petah Tiqva, Israel

    Rachel Maayan & Irit Gil-Ad

Authors
  1. Michael Poyurovsky
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  2. Camil Fuchs
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  3. Artashez Pashinian
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  4. Aya Levi
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  5. Sarit Faragian
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Correspondence to Michael Poyurovsky.

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Poyurovsky, M., Fuchs, C., Pashinian, A. et al. Attenuating effect of reboxetine on appetite and weight gain in olanzapine-treated schizophrenia patients: a double-blind placebo-controlled study. Psychopharmacology 192, 441–448 (2007). https://doi.org/10.1007/s00213-007-0731-1

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  • DOI: https://doi.org/10.1007/s00213-007-0731-1

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