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Course and predictors of weight gain in people with first-episode psychosis treated with olanzapine or haloperidol

Department of Psychiatry,University of Toronto Faculty of Medicine, Toronto, Ontario, Canada

Hongbin Gu, PhD

Department of Psychiatry,University of North Carolina School of Medicine, Chapel Hill, North Carolina

Alan I. Green, MD

Department of Psychiatry, Dartmouth Medical School, Hanover, New Hampshire

Diana O. Perkins, MD, MPH

Department of Psychiatry,University of North Carolina School of Medicine, Chapel Hill, North Carolina

Mauricio F. Tohen, MD, DrPH

Lilly Research Laboratories, Indianapolis, Indiana

Joseph P. McEvoy, MD

Department of Psychiatry, Duke University School of Medicine, Durham, North Carolina

Stephen M. Strakowski, MD

Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio, USA

Tonmoy Sharma, MD

Clinical Neuroscience Research Centre, Kent, UK

René S. Kahn, MD, PhD

Department of Psychiatry, University of Utrecht Medical School,Utrecht,The Netherlands

Raquel E. Gur, MD, PhD

University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

Gary D. Tollefson, MD, PhD

Lilly Research Laboratories, Indianapolis, Indiana

Jeffrey A. Lieberman, MD

Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York,USA

on behalf of the HGDH Study Group

Correspondence: Dr Robert B. Zipursky, Schizophrenia Programme,Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario, Canada M5T 1R8. Tel: +1 416 979 6913; fax: +1 416 979 4676; e-mail: robert_zipursky{at}camh.net

Declaration of interest This work was financially supported by Lilly Research Laboratories. M.F.T. and G.D.T. are employees of Lilly Research Laboratories.

Background Substantial weight gain is common with many atypical antipsychotics.

Aims To evaluate the extent, time course and predictors of weight gain and its effect on study retention among people with first-episode psychosis treated with olanzapine or haloperidol.

Method Survival analysis assessed time to potentially clinically significant weight gain (7%) and the effect of weight gain on study retention. Weight gain during the 2-year study was summarised using last-observation-carried-forward (LOCF), observed cases and study completion approaches.

Results After 2 years of treatment, LOCF mean weight gain was 10.2 kg (s.d.=10.1) for olanzapine (n=131) and 4.0 kg (s.d.=7.3) for haloperidol (n=132); observed cases mean weight gain was 15.4 kg (s.d.=10.0) for olanzapine and 7.5 kg (s.d.=9.2) for haloperidol. Change in body massindex was significantly predicted only by treatment group (P < 0.0001).

Conclusions Olanzapine was associated with significantly greater weight gain than haloperidol, with both leading to greater weight gain than previously described.

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