ABSTRACT
OBJECTIVE: Clinical factors predicting weight change in patients with schizophrenia and related disorders during acute treatment with the antipsychotic drugs olanzapine, risperidone, and haloperidol were sought through retrospective analyses. METHOD: Six-week body-weight data from 2 trials, study 1 comparing olanzapine and haloperidol (N = 1,369) and study 2 olanzapine and risperidone (N = 268), were analyzed. Effects of 8 clinically relevant covariates--therapy, clinical outcome (Brief Psychiatric Rating Scale), baseline body mass index (BBMI), increased appetite, age, gender, race, and dose--on weight were compared. RESULTS: In study 1, olanzapine (vs. haloperidol) therapy, better clinical outcome, lower BBMI, and nonwhite race significantly affected weight gain. Effects of increased appetite and male gender on weight gain were significant for olanzapine but not for haloperidol. In study 2, better clinical outcome, lower BBMI, and younger age significantly affected weight gain. Increased appetite was more frequent during olanzapine treatment than during haloperidol, but not significantly different from risperidone. Significant differences in effect on weight change were found between olanzapine and haloperidol but not between olanzapine and risperidone. No evidence was found that lower antipsychotic drug doses were associated with lower weight gain. CONCLUSION: This report identifies predictive factors of acute weight change in patients with schizophrenia. Similar factors across antipsychotic drugs in predicting greater weight gain included better clinical outcome, low BBMI, and nonwhite race. Factors differing between conventional (haloperidol) and atypical (olanzapine) agents included increased appetite and gender. Choice of atypical antipsychotic drug (olanzapine vs. risperidone) was of minor importance with regard to influence on acute weight gain.
Subject(s)
Antipsychotic Agents/therapeutic use , Body Weight/drug effects , Haloperidol/therapeutic use , Pirenzepine/analogs & derivatives , Pirenzepine/therapeutic use , Risperidone/therapeutic use , Schizophrenia/drug therapy , Adult , Age Factors , Antipsychotic Agents/pharmacology , Appetite/drug effects , Benzodiazepines , Body Mass Index , Brief Psychiatric Rating Scale/statistics & numerical data , Dose-Response Relationship, Drug , Double-Blind Method , Female , Follow-Up Studies , Haloperidol/pharmacology , Humans , Male , Olanzapine , Pirenzepine/pharmacology , Racial Groups , Retrospective Studies , Risk Factors , Risperidone/pharmacology , Sex Factors , Treatment Outcome , Weight Gain/drug effectsABSTRACT
Nettleship-Falls ocular albinism is an X-linked disorder characterized by variable degrees of impaired visual acuity, nystagmus, and macular hypoplasia in affected males and variable fundus pigmentation but normal acuities in females. Because of extreme variability in clinical manifestation, examination of family members may be necessary to confirm the diagnosis and is essential for genetic counseling purposes. This study reports the pedigree analysis and clinical findings in a large kindred from rural Virginia with 31 males reported to be affected among the 287 individuals in the pedigree. Clinical findings were quite variable, even within sibships, and some cases had been previously misdiagnosed, even in the presence of this remarkable family history. Linkage analysis in this family did not show the expected linkage with the Xg blood group. Examination of skin biopsies clearly indicated the cutaneous abnormality of giant pigment melanosomes (GPM) in both affected males and carrier females. Our use of light microscopy for detection of characteristic GPM may be easily employed as a carrier detection test, and therefore, provide the basis for accurate genetic counseling in families with ocular albinism.
