Psychiatric Medication Linked to Weight Gain in Kids

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“Drugs that alleviate severe mental disorders can also result in troubling metabolic changes,” says ScienceNews.org in an article released today.  According to the Journal of the American Medical Association, children who are on psychiatric medication often gain a substantial amount of weight and may have high levels of cholesterol and triglycerides.

It’s worth mentioning that this data is in the early stages of study, and it must be replicated over a larger area of study until results can be completely conclusive.  However, the information provided in this study has certainly raised some worrisome thoughts.

The focus of this study is on anti-psychotic drugs; those that alleviate the ill effects of severe bipolar disorder, aggression, autism, schizophrenia, and tics in children.  Coauthor of this new study, Christoph Correll, a psychiatrist from Zucker Hillside Hospital in Glen Oaks, NY, says, “We’re stuck between a rock and a hard place here.  These mental disorders are severe and can lead to suicide or to educational problems and emotional scars, he says. On the other hand, weight gain during youth predisposes an individual to chronic health problems later in life.”

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Though weight gain has been observed as a, for all intents and purposes, general side effect of many psychiatric drugs, the goal of linking the direct cause of the weight gain to the drugs has been a difficult process.  However, according to the American Medical Association, in the new study, Correll and his colleagues monitored 272 children, ages 4 to 19, between 2001 and 2007. Of these, 257 were getting psychotropics for severe problems for the first time, and 15 others refused the drugs but agreed to be seen by a doctor. The drugs were olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal) or aripiprazole (Abilify). Restricting the study to first-timers eliminated problems encountered in earlier studies.

After a median follow-up period of nearly 11 weeks, these patients had gained 10 to 19 pounds on average, depending on the drug. Kids on Zyprexa gained the most, on average, while those taking Abilify gained the least. The 15 patients who had refused drug treatment gained less than one pound on average during the monitoring period.

The pace of weight gain seems to level off over time, Correll says, but further study will be needed to clarify that trend.

“This is a really good study of relatively short-term effects,” says Christopher Varley, a child psychiatrist at the University of Washington School of Medicine and Seattle Children’s Hospital. But longer-term data are needed, he says, “because you never really treat a kid with one of these conditions for only 12 weeks — it’s more like six to nine months or a year or two.”

Correll’s team intends to monitor as many of the patients as possible over a longer time period.

Child psychiatrist Linmarie Sikich of the University of North Carolina at Chapel Hill School of Medicine says that she and her colleagues have seen many patients lose weight after coming off these drugs. So far, researchers don’t have enough data to clarify why some patients lose the weight and others don’t, she says.

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The biological mechanism underlying the weight gain also remains obscure, Varley says. But some effects are evident, such as carbohydrate cravings. “The appetite of these youngsters dramatically goes up,” he says. At the same time, the drugs have a mild sedative effect. “They’re not out running around, expending calories.”

Sikich says some evidence suggests that the drugs may block the body’s satiety signal.

Meanwhile, patients in this study taking Zyprexa showed increased LDL cholesterol and triglycerides, types of fat in the blood. Patients getting Seroquel also had higher triglycerides. The other drugs showed little change in these metabolic markers.

“This does leave a difficult decision, but I think we’re getting increasing guidance,” Sikich says. Clinicians would prefer to prescribe the drugs with the mildest side effects, she notes.

While all four drugs are cleared for adults, the U.S. Food and Drug Administration has specifically approved only Abilify and Risperdal for pediatric use thus far. Earlier this year, a panel of experts recommended that the FDA approve all four drugs for certain severe psychiatric problems in children. The regulatory body has yet to rule on that.

Sources: ScienceNews.org, Scientific American, Journal of the American Medical Association

Tags: Biology, Brain, Chemistry, Kids, Medication, Neurology, Pharmacy, Psychiatry, Psychology, Weight Gain