One of the most discouraging side effects of many antipsychotic drugs is their tendency to create metabolic changes in the patient. These changes generally include weight gain and hormonal imbalances. An increased body mass index then generates all sorts of secondary health risks, such as heart disease, type 2 diabetes, and impaired organ function. In both women and men, hormonal fluctuations can lead to sexual dysfunction, infertility, and a greater likelihood of developing certain forms of cancer. In the schizophrenic population, these risks have largely been accepted as worthwhile in the face of the debilitating effects of profound psychoses. However, the last 10 or so years have witnessed the development of new pharmaceuticals that promise the same positive effects with potentially fewer adverse events. Abilify (aripiprazole) is one of these new medications, and recent studies have looked into the possibility of switching patients to this drug as part of a weight management program.
A study carried out in the Netherlands showed promising results for managing weight by way of a switch to Abilify. A total of 53 patients participated in the study, although only 55% of these continued for the entire trial. Body mass index and other data were recorded at the beginning of the study and again at the end, 52 weeks later. The long duration of the study meant that, ideally, any weight loss would be proven to be much more than a short-term phenomenon. There was no control group and the sample size was small, so hard and fast conclusions cannot be drawn from the results. Also, additional factors like changes in lifestyle or dietary habits were not taken into account. Still, the eventual results were positive enough that further research is definitely warranted.
At the end of the 52-week trial, nearly all the patients who continued with Abilify showed meaningful weight loss. The average loss was about 4% of starting body weight. A few patients did gain weight, but again, not all changes in weight can be attributed to the medication. The important point is that other antipsychotics almost universally result in significant weight gain. That Abilify does not have this effect is an important point for doctors to consider when prescribing medication for their patients. Switching from one antipsychotic drug to another can be risky. An increase in adverse events is often reported immediately after beginning a new drug, but it may be worth the risk if the odds of developing heart disease or diabetes can be lessened.
- Citrome, L., Vreeland, B. (2008). Schizophrenia, obesity, and antipsychotic medications: what can we do? Postgraduate Medicine, 120 (2), 18-33.
- Schorr, S. G., Sloof, C. J., Postema, R., Van Oven, W., Schilthuis, M., Bruggeman, R., Taxis, K. (2008). A 12-month follow-up study of treating overweight schizophrenic patients with aripiprazole. Acta Psychiatrica Scandinavica, 118, 246-250.
© Copyright 2011 by James Pendleton. All Rights Reserved. Permission to publish granted to GoodTherapy.org.
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