The aim of this study was to evaluate the mechanisms underlying weight gain induced by the atypical antipsychotic, olanzapine. We performed euglycemic, hyperinsulinemic clamp combined with indirect calorimetry on a 48-year-old male with antisocial personality disorder, alcohol dependence and paranoid ideation before and after one month of olanzapine (10 - 15 mg/day) therapy. The patient gave his informed, written consent for this study. The results were a weight gain of 6 kg and a decrease in both basal (from 1673 to 1613 kcal/24 h) and 3-hour (from 22.8 to 20.2 cal/kg fat free mass/min) energy expenditure. Serum thyroid hormone and high-density lipoprotein cholesterol levels decreased, and the triglyceride and low-density lipoprotein cholesterol levels increased. Insulin sensitivity did not change. We conclude that decreased basal energy expenditure may contribute to weight gain in olanzapine treatment.
References
-
1
Conley R R, Meltzer H Y.
Adverse events related to olanzapine.
J Clin Psychiatry.
2000;
61
(8)
26-29
-
2
Allison D B, Mentore J L, Heo M, Chandler L P, Cappelleri J C, Infante M C, Weiden P J.
Antipsychotic-induced weight gain: a comprehensive research synthesis.
Am J Psychiatry.
l999;
156
1686-1696
-
3
Taylor D M, McAskill R.
Atypical antipsychotics and weight gain-a systematic review.
Acta Psychiatr Scand.
2000;
101
416-432
-
4
Wirshing D A, Spellberg B J, Erhart S M, Marder S R, Wirshing W C.
Novel antipsychotics and new onset diabetes.
Biol Psychiatry.
1998;
44
778-783
-
5
Lindenmayer J P, Patel R.
Olanzapine-induced ketoacidosis with diabetes mellitus.
Am J Psychiatry.
1999;
156
1471
-
6
Devlin M J, Yanovski S Z.
Obesity: What mental health professionals need to know.
Am J Psychiatry.
2000;
157
854-866
-
7
DeFronzo R A.
Glucose intolerance and aging: Evidence for tissue insensitivity to insulin.
Diabetes.
l979;
28
1091-1111
-
8
Franssila-Kallunki A, Schalin-Jäntti C, Groop L.
Effect of gender on insulin resistance associated with aging.
Am J Physiol.
1992;
263 (Endocrinol Metab 26)
E780-E785
-
9
Ferrannini E.
The theoretical basis for indirect calorimetry: a review.
Metabolism.
1988;
37
287-301
-
10
Merilainen P T.
Metabolic monitor.
Inst I Clin Comput.
1987;
4
167-177
-
11 Franssila-Kallunki A. Energy metabolism in insulin resistant states. Academic Dissertation, Helsinki University. Helsinki Yliopistopaino 1994
-
12
Tappy L, Owen O E, Boden G.
Effects of hyperinsulinemia on urea pool size and substrate oxidation rates.
Diabetes.
1988;
17
1212-1216
-
13
Franssila-Kallunki A, Groop L.
Factors associated with basal metabolic rate in patients with type 2 (non-insulin dependent) diabetes mellitus.
Diabetologia.
1992;
35
962-966
-
14
Baptista T.
Body weight gain induced by antipsychotic drugs: mechanisms and management.
Acta Psychiatr Scand.
1999;
100
3-16
-
15
Kraus T, Haack M, Schuld A, Hinze-Selch D, Kuhn M, Uhr M, Pollmacher T.
Body weight and leptin plasma levels during treatment with antipsychotic drugs.
Am J Psychiatry.
1999;
156
312-314
-
16
Herran A, Garcia-Unzueta M T, Amado J A, de la Maza M T, Alvarez C, Vazquez-Barquero J L.
Effects of long-term treatment with antipsychotics on serum leptin levels.
Br J Psychiatry.
2001;
179
59-62
Matti VirkkunenMD, PhD
Department of Psychiatry, University of Helsinki
Lapinlahti Hospital
PO Box 320
00029 Huch
Finland
Telefon: +358 (9) 47 18 12 60
eMail: matti.virkkunen@huch.fi
