Téma: 

Schizophrenia, antipsychotics and obesity

Vladimír Novotný

Before psychotropic drugs were used psychiatrists noticed that schizophrenics are prone to obesity. This fact was foisted upon several causes, e.g. effect of particular symptoms of the disease (apathy, negative symptomatology), influence of unsociable way of life, lack of physical activity. However, further factors, e.g. irregular and unhealthy food and overall bad financial situation of schizophrenics can influence their weight gain. In the age of classical neuroleptics (or antipsychotics) the fact that they increase weight was generally known. Some of them more (chlorpromasin, tioridasin), others less or do not gain weight at all (haloperidol). The onset of the second generation of neuroleptics, s.c. atypical antipsychotics, drew the attention of specialists because obesity became the standard sign in schizophrenics. 10-fold increase of interest is during one decade is reported. Obesity or higher weight in patients with schizophrenia is in 75 %-80 % of patients, on other hand the weight reduction is seen in 20 %-25 % of patients. Substances causing histamine receptors block show in both short term and long term studies the highest weight gain (clozapin, olanzapin). Substances with no effect on histamine receptor system do not cause weight gain (ziprasidon, sertindol). Dietary regimen, increased physical activity, more intensive rehabilitation is recommended. Limited knowledge of therapeutic use of some medicinal substances with non-specific pharmacological action is available - amantadin, fenfluramin, chlórfentermin (risk of deterioration of psychosis), or antiobesics - sibutramin and orlistat.

Ročník 2005  Témy časopisu Internal medicine 2 / 2005

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