Adrian Heald, George Tilston, John Julian Warner-Levy, Loren Wilkins, Richard Williams, Toby Pillinger, William Deakin, Damien Longson, Lamiece Hassan, Caroline Dalton, Gavin P Reynolds, Joseph Firth
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Mean baseline body-mass-Index (BMI) was similar in women versus men. Substantial increases in BMI were observed, with the greatest categorical changes seen in the obese (BMI ≥ 30 kg/m<sup>2</sup>) subjects, increasing from 30 to 43% for women and from 26% to 39% for men, while 42% of people did not significantly increase their weight. Individuals prescribed perphenazine/fluphenazine/amisulpride were most likely to remain at normal-BMI, while individuals prescribed aripiprazole/quetiapine/olanzapine/risperidone in the first year were most likely to gain weight/transition to overweight (25.0-29.9 kg/m<sup>2</sup>)/obese (≥ 30.0 kg/m<sup>2</sup>) from a normal BMI. The 'typical' agents thioridazine/chlorpromazine/flupenthixol/trifluoperazine/haloperidol were associated with an intermediate likelihood of BMI category change. In multivariate linear regression, factors associated with weight-gain were younger age/female sex(both p < 0.001), number of antipsychotic agents prescribed in 1st year (p < 0.001), plus specific agents aripiprazole (including 75% co-prescription or as 2nd line/3rd line)/olanzapine/thioridazine (p < 0.001), risperidone/quetiapine (p < 0.05). In multivariate logistic regression (weight increase ≥ 7%), the specific medication factors were similar, with odds ratios(OR) for specific medications ranging from quetiapine 1.09 (CI 1.00-1.21) to thioridazine 1.45 (CI 1.20-1.74).</p><p><strong>Conclusion: </strong>Younger women were at elevated risk for weight gain as were people prescribed multiple antipsychotics in the 1st year. Some older antipsychotics associated with as much weight gain as the newer prescribed agents. More than 40% of people did not put on weight.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.9000,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of Early Antipsychotic Prescription Choice on Weight Gain in the First 5 Years of Psychotic Illness: a Retrospective Cohort Study.\",\"authors\":\"Adrian Heald, George Tilston, John Julian Warner-Levy, Loren Wilkins, Richard Williams, Toby Pillinger, William Deakin, Damien Longson, Lamiece Hassan, Caroline Dalton, Gavin P Reynolds, Joseph Firth\",\"doi\":\"10.1007/s40120-025-00780-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>We analysed the effects of antipsychotic drug prescribing in year 1 of treatment for psychosis on future weight gain over 5 years.</p><p><strong>Methods: </strong>We studied how weight changed over 5 years after the first diagnosis of psychosis/schizophrenia/schizoaffective disorder/delusional disorder/affective psychosis in 17,570 individuals and investigated its association with antipsychotic drug treatments prescribed in year 1 following diagnosis, over 30 years.</p><p><strong>Results: </strong>The majority (65%) were aged 20-59 years at the time of first antipsychotic prescription. 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Impact of Early Antipsychotic Prescription Choice on Weight Gain in the First 5 Years of Psychotic Illness: a Retrospective Cohort Study.
Introduction: We analysed the effects of antipsychotic drug prescribing in year 1 of treatment for psychosis on future weight gain over 5 years.
Methods: We studied how weight changed over 5 years after the first diagnosis of psychosis/schizophrenia/schizoaffective disorder/delusional disorder/affective psychosis in 17,570 individuals and investigated its association with antipsychotic drug treatments prescribed in year 1 following diagnosis, over 30 years.
Results: The majority (65%) were aged 20-59 years at the time of first antipsychotic prescription. Mean baseline body-mass-Index (BMI) was similar in women versus men. Substantial increases in BMI were observed, with the greatest categorical changes seen in the obese (BMI ≥ 30 kg/m2) subjects, increasing from 30 to 43% for women and from 26% to 39% for men, while 42% of people did not significantly increase their weight. Individuals prescribed perphenazine/fluphenazine/amisulpride were most likely to remain at normal-BMI, while individuals prescribed aripiprazole/quetiapine/olanzapine/risperidone in the first year were most likely to gain weight/transition to overweight (25.0-29.9 kg/m2)/obese (≥ 30.0 kg/m2) from a normal BMI. The 'typical' agents thioridazine/chlorpromazine/flupenthixol/trifluoperazine/haloperidol were associated with an intermediate likelihood of BMI category change. In multivariate linear regression, factors associated with weight-gain were younger age/female sex(both p < 0.001), number of antipsychotic agents prescribed in 1st year (p < 0.001), plus specific agents aripiprazole (including 75% co-prescription or as 2nd line/3rd line)/olanzapine/thioridazine (p < 0.001), risperidone/quetiapine (p < 0.05). In multivariate logistic regression (weight increase ≥ 7%), the specific medication factors were similar, with odds ratios(OR) for specific medications ranging from quetiapine 1.09 (CI 1.00-1.21) to thioridazine 1.45 (CI 1.20-1.74).
Conclusion: Younger women were at elevated risk for weight gain as were people prescribed multiple antipsychotics in the 1st year. Some older antipsychotics associated with as much weight gain as the newer prescribed agents. More than 40% of people did not put on weight.
期刊介绍：
Aims and Scope
Neurology and Therapy aims to provide reliable and inclusive, rapid publication for all therapy related research for neurological indications, supporting the timely dissemination of research with a global reach, to help advance scientific discovery and support clinical practice.
Neurology and Therapy is an international, open access, peer reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world and health outcomes research around the discovery, development, and use of neurological and psychiatric therapies, (also covering surgery and devices). Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also welcomed.
The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, case reports, trial designs, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Neurology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
Rapid Publication
The journal’s rapid publication timelines aim for a peer review decision within 2 weeks of submission. If an article is accepted, it will be published online 3-4 weeks from acceptance. These rapid timelines are achieved through the combination of a dedicated in-house editorial team, who closely manage article workflow, and an extensive Editorial and Advisory Board who assist with rapid peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model, this allows for the rapid and efficient communication of the latest research and reviews to support scientific discovery and clinical practice.
Open Access
All articles published by Neurology and Therapy are open access.
Personal Service
The journal’s dedicated in-house editorial team offer a personal “concierge service” meaning that authors will always have a personal point of contact able to update them on the status of their manuscript. The editorial team check all manuscripts to ensure that articles conform to the most recent COPE and ICMJE publishing guidelines. This supports the publication of ethically sound and transparent research. We also encourage pre-submission enquiries and are always happy to provide a confidential assessment of manuscripts.
Digital Features and Plain Language Summaries
Neurology and Therapy offers a range of additional features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by key summary points, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand the scientific content and overall implications of the article. The journal also provides the option to include various types of digital features including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations. All additional features are peer reviewed to the same high standard as the article itself. If you consider that your paper would benefit from the inclusion of a digital feature, please let us know. Our editorial team are able to create high-quality slide decks and infographics in-house, and video abstracts through our partner Research Square, and would be happy to assist in any way we can. For further information about digital features, please contact the journal editor (see ‘Contact the Journal’ for email address), and see the ‘Guidelines for digital features and plain language summaries’ document under ‘Submission guidelines’.
For examples of digital features please visit our showcase page https://springerhealthcare.com/expertise/publishing-digital-features/
Publication Fees
Upon acceptance of an article, authors will be required to pay the mandatory Rapid Service Fee of €5250/$6000/£4300. The journal will consider fee discounts and waivers for developing countries and this is decided on a case-by-case basis.
Peer Review Process
Upon submission, manuscripts are assessed by the editorial team to ensure they fit within the aims and scope of the journal and are also checked for plagiarism. All suitable submissions are then subject to a comprehensive single-blind peer review. Reviewers are selected based on their relevant expertise and publication history in the subject area. The journal has an extensive pool of editorial and advisory board members who have been selected to assist with peer review based on the afore-mentioned criteria.
At least two extensive reviews are required to make the editorial decision, with the exception of some article types such as Commentaries, Editorials and Letters which are generally reviewed by one member of the Editorial Board. Where reviews conflict, an Editorial Board Member will be contacted for further advice and a presiding decision. Manuscripts are then either accepted, rejected or authors are required to make major or minor revisions (both reviewer comments and editorial comments may need to be addressed. Once a revised manuscript is re-submitted, it is assessed along with the responses to reviewer comments and if it has been adequately revised, it will be accepted for publication. Accepted manuscripts are then copyedited and typeset by the production team before online publication. Appeals against decisions following peer review are considered on a case-by-case basis and should be sent to the journal editor, and authors are welcome to make rebuttals against individual reviewer comments, if appropriate.
Preprints
We encourage posting of preprints of primary research manuscripts on preprint servers, authors'' or institutional websites, and open communications between researchers whether on community preprint servers or preprint commenting platforms. Posting of preprints is not considered prior publication and will not jeopardize consideration in our journals.
Please see here for further information on preprint sharing: https://www.springer.com/gp/authors-editors/journal-author/journal-author-helpdesk/submission/1302#c16721550
Copyright
Neurology and Therapy is published under the Creative Commons Attribution-Noncommercial License, which allows users to read, copy, distribute, and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited. The author assigns the exclusive right to any commercial use of the article to Springer. For more information about the Creative Commons Attribution-Noncommercial License, click here: http://creativecommons.org/licenses/by-nc/4.0.
Contact
For more information about the journal, including pre-submission enquiries, please contact managing editor Lydia Alborn at lydia.alborn@springer.com.
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