Body Mass Index(BMI) Changes during Combination Therapy with Mood Stabilizers and Antipsychotics in Acute Mania / 대한정신약물학회지

ABSTRACT

OBJECTIVE: To estimate changes in body mass index (BMI) during the treatment of acute manic patients, we retrospectively analyzed the medical records of patients admitted to Inha University Medical Center between January 1997 and December 2005. METHODS: Ninety-nine patients were divided into six groups according to their treatment regimens: monotherapy with lithium or divalproex and combination therapy with lithium and haloperidol, lithium and olanzapine, divalproex and haloperidol, or divalproex and olanzapine. Their demographic and clinical characteristics were assessed on admission, and the BMI was measured on admission and every week for 4 weeks after treatment. RESULTS: The combination therapy groups of lithium and olanzapine and divalproex and olanzapine had significant increases in BMI in proportion to the exposure time to medication (p=0.000), and there was no significant difference in the increase in BMI between these two groups. The normal weight group tended to have a greater increase in BMI than the overweight and obesity groups (p=0.078). CONCLUSION: The combination of a mood stabilizer (lithium or divalproex) with olanzapine is associated with a greater increase in BMI than are other treatment regimens in the acute manic phase of bipolar I disorder. More attention to weight gain is needed in the prescription of medications in acute manic patients and further studies are needed.