olanzapine and Birth-Weight

Antipsychotic induced weight gain is a frequent reason for treatment discontinuation in psychosis, subsequently increasing the risk of relapse and negatively affecting patient well-being. The metabolic effect of weight gain and the subsequent risk of obesity constitute a major medical problem on the long term. Despite its consequences, to date few risk factors have been identified (age, gender, body mass index at baseline), with some authors suggesting the implication of early life stressful events, such as perinatal conditions. We aim to describe if a surrogate marker of intrauterine environment (birth weight) might predict weight gain in a cohort of 23 antipsychotic naïve patients at the onset of the psychotic disease evaluated during 16 weeks with olanzapine treatment and in another cohort of 24 psychosis-resistant patients initiating clozapine assessed for 18 weeks. Two independent linear mixed model analyses were performed in each cohort of patients, with prospective weight gain as the dependent variable, age, gender, body mass index, duration of treatment and time as independent variables. Only in naïve patients, weight gain due to antipsychotics was significantly associated with birth weight, while male gender and body mass index at baseline were associated in both cohorts of patients. Treatment-resistant psychotic patients under clozapine were older, had previous antipsychotic treatment and more years of disease, confounders that might have influence a non significant association. Our results suggest that early environmental events might be playing a role in weight evolution in naïve patients treated with antipsychotics.

Topics: Adult; Antipsychotic Agents; Birth Weight; Body Mass Index; Clozapine; Cohort Studies; Female; Humans; Male; Models, Biological; Olanzapine; Pregnancy; Prenatal Exposure Delayed Effects; Psychotic Disorders; Sex Factors; Weight Gain; Young Adult

Topics: Adult; Benzodiazepines; Birth Weight; Cohort Studies; Female; Follow-Up Studies; Humans; Infant, Newborn; Olanzapine; Overweight; Pregnancy; Prenatal Exposure Delayed Effects; Prospective Studies; Young Adult

The effects of in utero exposure to atypical antipsychotics on infant birth weight are unknown.. To determine whether atypical and typical antipsychotics differ in their effects on birth weight after maternal exposure during pregnancy.. Prospective data on gestational age and birth weight collected by the National Teratology Information Service for infants exposed to typical (n=45) and atypical (n=25) antipsychotics was compared with data for a reference group of infants (n=38).. Infants exposed to atypical antipsychotics had a significantly higher incidence of large for gestational age (LGA) than both comparison groups and a mean birth weight significantly heavier than those exposed to typical antipsychotics. In contrast those exposed to typical antipsychotics had a significantly lower mean birth weight and a higher incidence of small for gestational age infants than the reference group.. In utero exposure to atypical antipsychotic drugs may increase infant birth weight and risk of LGA.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Birth Weight; Clozapine; Female; Fetal Macrosomia; Gestational Age; Humans; Infant, Newborn; Male; Mental Disorders; Olanzapine; Pregnancy; Pregnancy Complications; Prenatal Exposure Delayed Effects; Prospective Studies; Statistics, Nonparametric