TY - JOUR
T1 - Correlates of weight gain during long-term risperidone treatment in children and adolescents
AU - Calarge, Chadi A.
AU - Nicol, Ginger
AU - Xie, Diqiong
AU - Zimmerman, Bridget
N1 - Funding Information:
The authors report no competing interests. Dr. Calarge has received research grant support from the National Institute of Mental Health, (NIMH), the National Alliance for Research in Schizophrenia and Depression (NARSAD), and the Children’s Miracle Network. Dr. Nicol has received research grant support from the National Institute of Mental Health, (NIMH), the National Alliance for Research in Schizophrenia and Depression (NARSAD), the Sydney R. Baer, Jr. Foundation, the Communities Helping Adolescent Depression and Suicide (CHADS) Coalition for Mental Health, the Dana Brown Charitable Trust Foundation and Pfizer Inc. She also receives royalties from Jones & Bartlett Learning for a pediatric metabolic monitoring form. Dr. Zimmerman and Dr. Xie have no conflict of interest to disclose.
Funding Information:
This study was funded by a 2005 Young Investigator Award and by the National Institute of Health (RR024979, R21MH080968, and K23MH085005). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. The authors thank the families and the staff in the University of Iowa Child and Adolescent Psychiatry clinic and in the Clinical Research Unit. We also acknowledge the helpful comments of John Newcomer, M.D. Aspects of this work have been presented at the 51th NCDEU Annual Meeting, June, 2011, Boca Raton, FL.
PY - 2012/5/29
Y1 - 2012/5/29
N2 - Background: Most clinical trials of antipsychotics in children are brief, failing to address their long-term safety, particularly when taken concurrently with other psychotropics. This hypothesis-generating analysis evaluates potential correlates of weight gain in children receiving extended risperidone treatment.Methods: Medically healthy 7-17 year-old patients treated with risperidone for six months or more were enrolled. Anthropometric measurements were conducted. Developmental and medication history was obtained from the medical record. Information related to birth weight, dietary intake, physical activity, and parental weight was collected. Mixed regression analyses explored the contribution of various demographic and clinical factors to age- and sex-adjusted weight and body mass index (BMI) z scores over the treatment period.Results: The sample consisted of 110 patients (89% males) with a mean age of 11.8 years (sd = 2.9) upon enrollment. The majority had an externalizing disorder and received 0.03 mg/kg/day (sd = 0.02) of risperidone, for 2.5 years (sd = 1.7), to primarily target irritability and aggression (81%). Polypharmacy was common with 71% receiving psychostimulants, 50% selective serotonin reuptake inhibitors (SSRIs), and 32% α 2-agonists. Weight and BMI z score were positively correlated with baseline weight at the start of risperidone, treatment duration, and the weight-adjusted dose of risperidone but inversely associated with the weight-adjusted dose of psychostimulants and the concurrent use of SSRIs and α 2-agonists. The effect of risperidone dose appeared to attenuate as treatment extended while that of psychostimulants became more significant. The rate of change in weight (or BMI) z score prior to and within the first 12 weeks of risperidone treatment did not independently predict future changes neither did birth weight, postnatal growth, dietary intake, physical activity, or parental weight.Conclusions: This comprehensive analysis exploring correlates of long-term weight (or BMI) change in risperidone-treated youths revealed that pharmacotherapy exerts significant but complex effects.Trial Registration: Not applicable.
AB - Background: Most clinical trials of antipsychotics in children are brief, failing to address their long-term safety, particularly when taken concurrently with other psychotropics. This hypothesis-generating analysis evaluates potential correlates of weight gain in children receiving extended risperidone treatment.Methods: Medically healthy 7-17 year-old patients treated with risperidone for six months or more were enrolled. Anthropometric measurements were conducted. Developmental and medication history was obtained from the medical record. Information related to birth weight, dietary intake, physical activity, and parental weight was collected. Mixed regression analyses explored the contribution of various demographic and clinical factors to age- and sex-adjusted weight and body mass index (BMI) z scores over the treatment period.Results: The sample consisted of 110 patients (89% males) with a mean age of 11.8 years (sd = 2.9) upon enrollment. The majority had an externalizing disorder and received 0.03 mg/kg/day (sd = 0.02) of risperidone, for 2.5 years (sd = 1.7), to primarily target irritability and aggression (81%). Polypharmacy was common with 71% receiving psychostimulants, 50% selective serotonin reuptake inhibitors (SSRIs), and 32% α 2-agonists. Weight and BMI z score were positively correlated with baseline weight at the start of risperidone, treatment duration, and the weight-adjusted dose of risperidone but inversely associated with the weight-adjusted dose of psychostimulants and the concurrent use of SSRIs and α 2-agonists. The effect of risperidone dose appeared to attenuate as treatment extended while that of psychostimulants became more significant. The rate of change in weight (or BMI) z score prior to and within the first 12 weeks of risperidone treatment did not independently predict future changes neither did birth weight, postnatal growth, dietary intake, physical activity, or parental weight.Conclusions: This comprehensive analysis exploring correlates of long-term weight (or BMI) change in risperidone-treated youths revealed that pharmacotherapy exerts significant but complex effects.Trial Registration: Not applicable.
KW - Adolescent
KW - Antipsychotics
KW - Child
KW - Obesity
KW - Predictors
KW - Risperidone
KW - Weight gain
UR - https://www.scopus.com/pages/publications/84861470878
U2 - 10.1186/1753-2000-6-21
DO - 10.1186/1753-2000-6-21
M3 - Article
C2 - 22643087
AN - SCOPUS:84861470878
SN - 1753-2000
VL - 6
JO - Child and Adolescent Psychiatry and Mental Health
JF - Child and Adolescent Psychiatry and Mental Health
M1 - 21
ER -