Phenotypic factors associated with amisulpride-induced weight gain in first-episode psychosis patients (from the OPTiMiSE cohort)

R. Pandit, D. Cianci, S. E. ter Hark, I. Winter-van Rossum, B. H. Ebdrup, B. V. Broberg, M. P. Garcia-Portilla, J. Bobes, C. H. Vinkers, R. S. Kahn, S. Guloksuz, A. D. R. Huitema, J. J. Luykx

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objective: Antipsychotic-induced weight gain (AiWG) is a debilitating adverse effect of most antipsychotics. First-episode psychosis patients are particularly vulnerable to the detrimental consequences of AiWG. Amisulpride has good efficacy and tolerability. We here aimed to identify the phenotypic factors associated with amisulpride-induced weight gain in first-episode psychosis patients. Method: Data were collected from the Optimization of Treatment and Management of Schizophrenia in Europe trial. Multivariable regression models with various phenotypic variables (N = 305) were performed with absolute AiWG and clinically relevant AiWG (≥7% AiWG) as outcomes. Results: Four weeks of amisulpride treatment increased body weight from 69.7 to 72.4 kg (P < 0.001). In the regression model of absolute AiWG, unemployment (β = 0.94, P = 0.016), younger age (β = −0.07, P = 0.031) and absence of current comorbid major depression disorder (β = −1.61, P = 0.034) were positively associated with absolute AiWG. In the regression model of clinically relevant AiWG, unemployment (OR = 2.83, P = 0.001), schizophreniform disorder (OR = 2.00, P = 0.025) and low baseline weight (OR = 0.97, P = 0.032) increased the likelihood of clinically relevant AiWG. Conclusions: Clinicians prescribing amisulpride should consider the relatively high susceptibility to AiWG in unemployed first-episode patients with psychosis, in particular young subjects with a diagnosis of schizophreniform disorder. We advise to carefully monitor these patients and, when needed, implement weight-reducing strategies.
Original languageEnglish
Pages (from-to)283-290
JournalActa Psychiatrica Scandinavica
Volume140
Issue number3
Early online date19 Jul 2019
DOIs
Publication statusPublished - 2019

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