OBJECTIVE: The authors studied weight gain mechanisms and energy balance in patients treated with olanzapine. METHOD: The body mass index of male schizophrenic adolescent inpatients treated with olanzapine (N=10) and of 10 matched patients treated with haloperidol (N=10) were measured at baseline and after 4 weeks of treatment. For the patients treated with olanzapine, caloric intake, resting energy expenditure, and physical activity (determined through accelerometry and heart rate monitoring) were assessed at baseline and after 4 weeks of treatment. RESULTS: Body mass index significantly increased in those treated with olanzapine but not in those given haloperidol. The increase in body mass index was due to an increase in caloric intake without change in diet composition. Olanzapine had no significant effect on resting energy expenditure. Daily energy expenditure was very low before and after treatment. CONCLUSIONS: Olanzapine-induced weight gain is associated with a general increase in caloric intake.
Epilepsy is common in individuals with autism spectrum disorder (ASD) and intellectual disabilities (ID). Antiepileptic medications, such as valproic acid (VPA), were associated with changes in BMI, metabolic syndrome, dyslipidemia, and hyperinsulinemia. This study aimed to investigate how epilepsy and antiepileptic treatments affect BMI, fasting blood glucose (FBG), and total cholesterol of individuals with ASD or ID. Data on epilepsy diagnoses, treatment with VPA, carbamazepine or other antiepileptics, BMI, FBG, and total cholesterol levels were obtained from the medical charts of 80 adults with ASD and 77 adults with ID and analyzed using appropriate statistical tools. Participants with epilepsy had lower BMI and FBG than participants without epilepsy (BMI: 23.18 ± 5.43 vs. 25.61 ± 5.74 kg/m2, respectively, F = 6.64, d.f. = 1.140; P = 0.011, FBG: 72.53 ± 11.26 vs. 79.98 ± 14.64 mg/dl, respectively, F = 10.46, d.f. = 1.135 P = 0.002). Those treated with VPA had lower total cholesterol levels compared with those untreated (156.56 ± 26.13 vs. 172.42 ± 33.82 mg/dl, respectively, F = 7.44, d.f. = 1.150; P = 0.007), but did not differ in BMI and FBG. Individuals with ASD or ID, and epilepsy were leaner and had lower FBG than those without epilepsy. In addition, total cholesterol levels were lower in VPA-treated participants than in untreated ones, but BMI and FBG levels were similar.
Background Cyproheptadine, an antiserotonergic agent, was used to treat neuroleptic-induced akathisia. Method In an open clinical trial 17 neuroleptic-treated patients with akathisia were administered cyproheptadine (16 mg/day) over 4 days. Assessment of akathisia, psychosis and depression were monitored by BAS, BPRS and HAM-D. Results All subjects showed improvement in the severity of akathisia, which in the majority (15/17) was of a marked degree. There was no aggravation of psychosis or depression. Symptoms of akathisia returned when cyproheptadine was discontinued. Conclusions Cyproheptadine may be useful in neuroleptic-induced akathisia.
Alteration in peripheral iron indices has been reported in a number of movement disorders, particularly Parkinson's disease. We hypothesized that iron stores may be diminished in children at an early stage of tic disorder.Using data retrieved from electronic medical records, we compared serum ferritin levels, an indicator of body iron store balance, in drug-naive children diagnosed for the first time with tic disorder (study group; N = 47, 32 boys/15 girls, aged 8.66 ± 3.17 years) compared to age- and sex-matched children with headaches (comparison group, n = 100, 62 boys/38 girls, aged 9.51 ± 3.15 years) treated in the same pediatric neurological clinic.Mean serum ferritin levels were significantly lower (-32%, p = 0.01) in the tic disorder group compared to the headache group. No significant differences were detected in circulatory hemoglobin, iron, transferrin, and platelet count between the two groups.Our findings suggest that body iron stores may be reduced in children with recent-onset tic disorder.
