Daily Dose Effects of Risperidone on Weight and Other Metabolic Parameters: A Prospective Cohort Study

Marianna Piras, PharmD; Céline Dubath, PhD; Mehdi Gholam, PhD; Nermine Laaboub, MSc; Claire Grosu, MSc; Franziska Gamma, MD, MSc; Alessandra Solida, MD; Kerstin Jessica Plessen, PhD; Armin von Gunten, MPhil, MD; Philippe Conus, MD; Chin B. Eap, PhD

J Clin Psychiatry 2022;83(4):21m14110

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Author Affiliations

Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
Center for Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
Les Toises Psychiatry and Psychotherapy Center, Lausanne, Switzerland
Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
Center for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland
Corresponding author: Chin B. Eap, PhD, Hôpital de Cery, 1008 Prilly—Lausanne, Switzerland ([email protected]).

References (42)

Annamalai A, Kosir U, Tek C. Prevalence of obesity and diabetes in patients with schizophrenia. World J Diabetes. 2017;8(8):390–396. PubMed CrossRef
DE Hert M, Correll CU, Bobes J, et al. Physical illness in patients with severe mental disorders. I. prevalence, impact of medications and disparities in health care. World Psychiatry. 2011;10(1):52–77. PubMed CrossRef
Lawrence D, Hancock KJ, Kisely S. The gap in life expectancy from preventable physical illness in psychiatric patients in Western Australia: retrospective analysis of population based registers. BMJ. 2013;346:f2539. PubMed CrossRef
Ringen PA, Engh JA, Birkenaes AB, et al. Increased mortality in schizophrenia due to cardiovascular disease: a non-systematic review of epidemiology, possible causes, and interventions. Front Psychiatry. 2014;5:137. PubMed CrossRef
Singh R, Bansal Y, Medhi B, et al. Antipsychotics-induced metabolic alterations: Recounting the mechanistic insights, therapeutic targets and pharmacological alternatives. Eur J Pharmacol. 2019;844:231–240. PubMed CrossRef
Abosi O, Lopes S, Schmitz S, et al. Cardiometabolic effects of psychotropic medications. Horm Mol Biol Clin Investig. 2018;36(1):/j/hmbci.2018.36.issue-1/hmbci-2017-0065/hmbci-2017-0065.xml. PubMed
Ward A, Quon P, Abouzaid S, et al. Cardiometabolic consequences of therapy for chronic schizophrenia using second-generation antipsychotic agents in a Medicaid population: clinical and economic evaluation. P&T. 2013;38(2):109–115. PubMed
Gebhardt S, Haberhausen M, Heinzel-Gutenbrunner M, et al. Antipsychotic-induced body weight gain: predictors and a systematic categorization of the long-term weight course. J Psychiatr Res. 2009;43(6):620–626. PubMed CrossRef
Carliner H, Collins PY, Cabassa LJ, et al. Prevalence of cardiovascular risk factors among racial and ethnic minorities with schizophrenia spectrum and bipolar disorders: a critical literature review. Compr Psychiatry. 2014;55(2):233–247. PubMed CrossRef
De Hert M, Detraux J, van Winkel R, et al. Metabolic and cardiovascular adverse effects associated with antipsychotic drugs. Nat Rev Endocrinol. 2011;8(2):114–126. PubMed CrossRef
Barton BB, Segger F, Fischer K, et al. Update on weight-gain caused by antipsychotics: a systematic review and meta-analysis. Expert Opin Drug Saf. 2020;19(3):295–314. PubMed CrossRef
De Hert M, Yu W, Detraux J, et al. Body weight and metabolic adverse effects of asenapine, iloperidone, lurasidone and paliperidone in the treatment of schizophrenia and bipolar disorder: a systematic review and exploratory meta-analysis. CNS Drugs. 2012;26(9):733–759. PubMed CrossRef
Donohue J, O’Malley AJ, Horvitz-Lennon M, et al. Changes in physician antipsychotic prescribing preferences, 2002-2007. Psychiatr Serv. 2014;65(3):315–322. PubMed CrossRef
Dorsey ER, Rabbani A, Gallagher SA, et al. Impact of FDA black box advisory on antipsychotic medication use. Arch Intern Med. 2010;170(1):96–103. PubMed CrossRef
Weiden PJ, Mackell JA, McDonnell DD. Obesity as a risk factor for antipsychotic noncompliance. Schizophr Res. 2004;66(1):51–57. PubMed CrossRef
Kane JM, Correll CU. Past and present progress in the pharmacologic treatment of schizophrenia. J Clin Psychiatry. 2010;71(9):1115–1124. PubMed CrossRef
Simon V, van Winkel R, De Hert M. Are weight gain and metabolic side effects of atypical antipsychotics dose dependent? a literature review. J Clin Psychiatry. 2009;70(7):1041–1050. PubMed CrossRef
Carr CN, Lopchuk S, Beckman ME, et al. Evaluation of the use of low-dose quetiapine and the risk of metabolic consequences: a retrospective review. Ment Health Clin. 2016;6(6):308–313. PubMed CrossRef
Williams SG, Alinejad NA, Williams JA, et al. Statistically significant increase in weight caused by low-dose quetiapine. Pharmacotherapy. 2010;30(10):1011–1015. PubMed CrossRef
Pillinger T, McCutcheon RA, Vano L, et al. Comparative effects of 18 antipsychotics on metabolic function in patients with schizophrenia, predictors of metabolic dysregulation, and association with psychopathology: a systematic review and network meta-analysis. Lancet Psychiatry. 2020;7(1):64–77. PubMed
Xiang Q, Zhao X, Zhou Y, et al. Effect of CYP2D6, CYP3A5, and MDR1 genetic polymorphisms on the pharmacokinetics of risperidone and its active moiety. J Clin Pharmacol. 2010;50(6):659–666. PubMed CrossRef
Peuskens J; Risperidone Study Group. Risperidone in the treatment of patients with chronic schizophrenia: a multi-national, multi-centre, double-blind, parallel-group study versus haloperidol. Br J Psychiatry. 1995;166(6):712–726, discussion 727–733. PubMed CrossRef
Marder SR, Meibach RC. Risperidone in the treatment of schizophrenia. Am J Psychiatry. 1994;151(6):825–835. PubMed
Lane HY, Chang YC, Cheng YC, et al. Effects of patient demographics, risperidone dosage, and clinical outcome on body weight in acutely exacerbated schizophrenia. J Clin Psychiatry. 2003;64(3):316–320. PubMed CrossRef
Kelly DL, Conley RR, Love RC, et al. Weight gain in adolescents treated with risperidone and conventional antipsychotics over six months. J Child Adolesc Psychopharmacol. 1998;8(3):151–159. PubMed CrossRef
Hellings JA, Zarcone JR, Crandall K, et al. Weight gain in a controlled study of risperidone in children, adolescents and adults with mental retardation and autism. J Child Adolesc Psychopharmacol. 2001;11(3):229–238. PubMed CrossRef
Cohen S, Glazewski R, Khan S, et al. Weight gain with risperidone among patients with mental retardation: effect of calorie restriction. J Clin Psychiatry. 2001;62(2):114–116. PubMed CrossRef
Csernansky JG, Mahmoud R, Brenner R; Risperidone-USA-79 Study Group. A comparison of risperidone and haloperidol for the prevention of relapse in patients with schizophrenia. N Engl J Med. 2002;346(1):16–22. PubMed CrossRef
Fleischhacker WW, Eerdekens M, Karcher K, et al. Treatment of schizophrenia with long-acting injectable risperidone: a 12-month open-label trial of the first long-acting second-generation antipsychotic. J Clin Psychiatry. 2003;64(10):1250–1257. PubMed CrossRef
O’Donoghue B, Schäfer MR, Becker J, et al. Metabolic changes in first-episode early-onset schizophrenia with second-generation antipsychotics. Early Interv Psychiatry. 2014;8(3):276–280. PubMed CrossRef
Lin CH, Kuo CC, Chou LS, et al. A randomized, double-blind comparison of risperidone versus low-dose risperidone plus low-dose haloperidol in treating schizophrenia. J Clin Psychopharmacol. 2010;30(5):518–525. PubMed CrossRef
Dubath C, Delacrétaz A, Glatard A, et al. Evaluation of cardiometabolic risk in a large psychiatric cohort and comparison with a population-based sample in Switzerland. J Clin Psychiatry. 2020;81(3):19m12796. PubMed CrossRef
Turkoz I, Bossie CA, Lindenmayer JP, et al. Paliperidone ER and oral risperidone in patients with schizophrenia: a comparative database analysis. BMC Psychiatry. 2011;11(1):21. PubMed CrossRef
Pinheiro JBD, DebRoy S, Sarkar D. R Core Team. nlme: Linear and Nonlinear Mixed Effects Models. 2021.https://CRAN.R-project.org/package=nlme.
Risperdal. Highlights of Prescribing Information. Ortho-McNeil-Janssen Pharmaceuticals; 2009. https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/020272s056,020588s044,021346s033,021444s03lbl.pdf. 2008. Accessed July 12, 2020.
Vandenberghe F, Gholam-Rezaee M, Saigí-Morgui N, et al. Importance of early weight changes to predict long-term weight gain during psychotropic drug treatment. J Clin Psychiatry. 2015;76(11):e1417–e1423. PubMed CrossRef
Lee S-Y, Park M-H, Patkar AA, et al. A retrospective comparison of BMI changes and the potential risk factors among schizophrenic inpatients treated with aripiprazole, olanzapine, quetiapine or risperidone. Prog Neuropsychopharmacol Biol Psychiatry. 2011;35(2):490–496. PubMed CrossRef
Pérez-Iglesias R, Martínez-García O, Pardo-Garcia G, et al. Course of weight gain and metabolic abnormalities in first treated episode of psychosis: the first year is a critical period for development of cardiovascular risk factors. Int J Neuropsychopharmacol. 2014;17(1):41–51. PubMed CrossRef
Tarricone I, Ferrari Gozzi B, Serretti A, et al. Weight gain in antipsychotic-naive patients: a review and meta-analysis. Psychol Med. 2010;40(2):187–200. PubMed CrossRef
De Hert M, Dobbelaere M, Sheridan EM, et al. Metabolic and endocrine adverse effects of second-generation antipsychotics in children and adolescents: a systematic review of randomized, placebo controlled trials and guidelines for clinical practice. Eur Psychiatry. 2011;26(3):144–158. PubMed CrossRef
Rummel-Kluge C, Komossa K, Schwarz S, et al. Head-to-head comparisons of metabolic side effects of second generation antipsychotics in the treatment of schizophrenia: a systematic review and meta-analysis. Schizophr Res. 2010;123(2-3):225–233. PubMed CrossRef
Scordo MG, Spina E, Facciolà G, et al. Cytochrome P450 2D6 genotype and steady state plasma levels of risperidone and 9-hydroxyrisperidone. Psychopharmacology (Berl). 1999;147(3):300–305. PubMed CrossRef