Association between second-generation antipsychotics and changes in body mass index in adolescents.

Sameer R Ghate, Christina A Porucznik, Qayyim Said, Mia Hashibe, Elizabeth Joy, Diana I Brixner

Index: J. Adolesc. Health 52(3) , 336-43, (2013)

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Abstract

To assess the association of second-generation antipsychotics (SGAs) with changes in body mass index (BMI) among adolescents compared with a matched untreated comparison group.A retrospective cohort study was conducted using an electronic medical record database between January 2004 and July 2009. Adolescents (12-19 years old), newly initiated on SGAs formed the exposure group and untreated adolescents formed the comparison group matched (3:1) to the antipsychotic group based on age, gender, and month of index SGA. Both the exposure and comparison groups were followed for slightly more than a year (395 days). Baseline and follow-up BMI were evaluated for both groups and percentage change from baseline BMI to follow-up BMI was calculated. Multivariate linear regression was conducted to assess the impact of SGAs on percent change in follow-up BMI from baseline controlling for demographic characteristics, baseline medications, comorbidities, and other covariates.The mean percentage increase in follow-up BMI from baseline for antipsychotic group was significantly higher than the comparison group (p < .01). After adjusting for covariates, adolescents on olanzapine had the highest percentage increase in follow-up BMI from baseline (5.84%, 95% confidence interval [CI], 4.07-7.61) followed by aripiprazole (4.36%; 95% CI, 3.08-5.64), risperidone (3.65%; 95% CI, 2.61-4.68), and quetiapine (1.53%; 95% CI, .53-2.52) compared with the comparison group.This study further validates a growing concern of increased BMI in adolescents on SGA therapy.Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.