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Volume 4: No. 3, July 2007
LETTER TO THE EDITOR
Medical Treatment and Weight Gain
Suggested citation for this article: McGinn E. Medical treatment and weight gain
[letter to the editor]. Prev Chronic Dis [serial online] 2007
Jul [date cited]. Available from:
http://www.cy118119.com/pcd/issues/2007/
jul/07_0081.htm.
To the Editor:
揂ddressing the Obesity Epidemic: A Genomics Perspective?in your April 2007
(1) issue speaks of the importance of considering all aspects of obesity.
However, one aspect overlooked in the article is weight gain associated
with medical treatment. Many classes of drugs are associated with weight gain
that leads to overweight or obesity; these include atypical antipsychotic drugs,
lithium, some antidepressant drugs, some antiepileptic drugs, and some steroids.
Other drugs are associated with fat redistribution (e.g., some drugs for
HIV/AIDS).
In addition to increasing weight, atypical antipsychotic drugs increase risk
for hyperglycemia (as noted in a black-box label required by the Food and Drug
Administration [FDA]), and they are associated with爈ipid dysregulation
(2). Atypical antipsychotic drugs induce excitation and爃ypomania or mania, adverse effects never reported for the older versions of typical antipsychotic drugs
(3).燬ome atypical antipsychotic drugs are燼lso noncardiac QTc-interval–prolonging drugs and
are associated with increased sudden cardiac death
(4).牋?/p>
Atypical antipsychotic drugs are widely used off-label.燭he FDA issued a Public Health Advisory warning of a 60% to 70% increased risk for mortality among elderly people with dementia
being treated with atypical antipsychotic medications (5). From 1993 through
2002, prescriptions for atypical antipsychotic drugs for American children
increased 500% (all off-label);
85% of those prescriptions were for nonpsychotic conditions (6).燭he
public health implications of wide off-label use of爐his class of drugs merits more study.
Eileen McGinn, MPH
Student
Hunter College of the City University of New York
Brookdale Center for Healthy Aging and Longevity
New York, NY
Read the author’s reply
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References
- Newell A, Zlot
A, Silvey K, Ariail K.
Addressing the obesity epidemic: a genomics perspective. Prev Chronic Dis
[serial online] 2007 Apr.
- Newcomer JW.?a title="See PubMed article abstract" target="_blank" >Metabolic considerations in the use of antipsychotic medications: a review of recent evidence. J Clin Psychiatry?007;68 Suppl 1:20-7.
- Rachid F, Bertschy G, Bondolfi G, Aubry JM.?a title="See PubMed article abstract" target="_blank" >Possible induction of mania or hypomania by atypical antipsychotics: an updated review of reported
cases.燡 Clin Psychiatry 2004 Nov;65(11):1537-45.
- Straus SM, Sturkenboom MC, Bleumink GS, Dieleman JP, van der
Lei J, de Graeff PA, et al.?a title="See PubMed article abstract" target="_blank" >Non-cardiac QTc-prolonging drugs and the risk of sudden cardiac death. Eur Heart J 2005;26(19):2007-12.
- Public health advisory: deaths with antipsychotics in elderly patients with
behavioral disturbances.燫ockville (MD): Food and Drug Administration; 2005.
- Olfson M, Blanco C, Liu L, Moreno C, Laje G. National trends in the outpatient treatment of children and adolescents with antipsychotic drugs. Arch Gen Psychiatry 2006;63(6):679-85.
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