Impact of Antipsychotic Medications on Weight Gain and Eating Disorder-Related Psychopathology in Adult Inpatients with Anorexia Nervosa.

IF 3.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Pharmacopsychiatry Pub Date : 2024-11-19 DOI:10.1055/a-2436-9552

Tabea Bauman, David R Kolar, Christoph U Correll, Verena Haas, Ulrich Voderholzer

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Abstract

Introduction: The impact of antipsychotic use on weight gain and eating disorder-related psychopathology in adult inpatients with anorexia nervosa (AN) is unclear.

Methods: Consecutively hospitalized adults with AN were retrospectively analyzed. Co-primary outcomes were body mass index (BMI) and weekly weight change. Secondary outcomes were Eating Disorder Inventory-2 (EDI-2) subscale scores 'drive for thinness' and 'body dissatisfaction'. Admission-to-discharge changes were compared in patients continuing pre-admission antipsychotics (APcont), starting antipsychotics (APnew) and patients without psychopharmacotherapy (noMed) using linear mixed models. Sensitivity analyses were conducted in subgroups matched for age, length of stay, baseline BMI and baseline EDI-2 scores. Subgroups were also compared regarding BMI trajectories, using non-linear growth curve models. Within-group analyses compared weight gain before vs. after the median antipsychotic onset week.

Results: Of 775 adult inpatients (mean length of stay =103.5±48.0 days), 21.7% received antipsychotics (APcont =7.7%; APnew=13.9%), i. e., olanzapine (n=127, dose =5.5±3.1 mg/day) or quetiapine (n=41, dose=100.0±97.7 mg/day), while 78.3% did not receive any medication. Comparing all three groups, a significant time×group interaction was found for noMed and APnew vs. APcont (p=0.011), but this effect disappeared when comparing matched subgroups. However, in matched subgroups (n=54 each) APnew showed steeper weight gain vs. APcont both overall (p=0.011) and after median antipsychotic initiation (5.8±5.0 weeks) (p≤0.001). No significant group differences emerged in EDI-2 subscale scores.

Discussion: In this naturalistic study, 22% of adult inpatients received antipsychotics. However, neither weight gain nor AN-related psychopathology changed differently in patients treated with vs. without antipsychotics. Newly initiated antipsychotic treatment vs. continuation from pre-admission had better weight gain outcomes.

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抗精神病药物对成年神经性厌食症住院患者体重增加和进食障碍相关精神病理学的影响。

简介：使用抗精神病药物对神经性厌食症（AN）成人住院患者体重增加和进食障碍相关精神病理学的影响尚不清楚：使用抗精神病药物对神经性厌食症（AN）成人住院患者体重增加和进食障碍相关精神病理学的影响尚不清楚：方法：对连续住院的成人厌食症患者进行回顾性分析。共同主要结果为体重指数（BMI）和每周体重变化。次要结果是饮食失调量表-2（EDI-2）的 "追求瘦 "和 "身体不满意 "分量表得分。使用线性混合模型比较了入院前继续使用抗精神病药物（APcont）、开始使用抗精神病药物（APnew）和未接受精神药物治疗（noMed）的患者入院至出院期间的变化。对年龄、住院时间、基线体重指数和基线 EDI-2 评分相匹配的亚组进行了敏感性分析。此外，还使用非线性增长曲线模型对各分组的体重指数轨迹进行了比较。组内分析比较了抗精神病药物起始周中位数之前和之后的体重增加情况：在775名成年住院患者（平均住院时间=103.5±48.0天）中，21.7%接受了抗精神病药物治疗（APcont=7.7%；APnew=13.9%），即奥氮平（n=127，剂量=5.5±3.1 mg/天）或喹硫平（n=41，剂量=100.0±97.7 mg/天），78.3%未接受任何药物治疗。比较所有三组，发现 noMed 和 APnew 与 APcont 存在显著的时间×组交互作用（p=0.011），但在比较匹配的亚组时，这种效应消失了。然而，在匹配的亚组（每组 n=54 人）中，APnew 与 APcont 相比，在总体上（p=0.011）和抗精神病药物起始时间中位数（5.8±5.0 周）后（p≤0.001），体重增加的速度都更快（p=0.011）。在EDI-2分量表得分方面没有出现明显的组间差异：在这项自然研究中，22%的成年住院患者接受了抗精神病药物治疗。然而，在使用与未使用抗精神病药物的患者中，体重增加和与自闭症相关的精神病理学都没有发生不同的变化。新开始使用抗精神病药物治疗与入院前继续使用抗精神病药物治疗相比，体重增加的效果更好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pharmacopsychiatry 医学-精神病学

CiteScore

7.10

自引率

9.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Covering advances in the fi eld of psychotropic drugs, Pharmaco psychiatry provides psychiatrists, neuroscientists and clinicians with key clinical insights and describes new avenues of research and treatment. The pharmacological and neurobiological bases of psychiatric disorders are discussed by presenting clinical and experimental research.