Treatment Discontinuation Impact on Long-Term (10-Year) Weight Gain and Lipid Metabolism in First-Episode Psychosis: Results From the PAFIP-10 Cohort

Int J Neuropsychopharmacol. 2021 Jan 20;24(1):1-7. doi: 10.1093/ijnp/pyaa066.

Abstract

Background: Patients with a first episode of psychosis (FEP) are at higher risk of gaining weight and presenting metabolic disturbances, partly related to antipsychotic exposure. Previous studies suggest that treatment discontinuation might have a positive impact on weight in schizophrenia. The aim of this study was to evaluate the effect of treatment discontinuation on weight and metabolic changes in a FEP cohort.

Methods: A total of 209 FEP patients and 57 healthy controls were evaluated at study entry and prospectively at 10-year follow-up. Anthropometric measures and, clinical, metabolic, and sociodemographic data were collected.

Results: Patients discontinuing antipsychotic treatment presented a significantly lower increase in weight and better metabolic parameter results than those still on antipsychotic treatment at 10-year follow-up.

Conclusions: Treatment discontinuation had a positive effect on the weight and metabolic changes observed in FEP patients; however, this effect was not sufficient to reaching a complete reversal to normal levels.

Keywords: Treatment discontinuation; lipid metabolism; medication-naïve; second-generation antipsychotic; weight gain.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antipsychotic Agents / administration & dosage*
  • Antipsychotic Agents / adverse effects*
  • Female
  • Humans
  • Lipid Metabolism / drug effects*
  • Longitudinal Studies
  • Male
  • Psychotic Disorders / drug therapy*
  • Time Factors
  • Weight Gain / drug effects*
  • Young Adult

Substances

  • Antipsychotic Agents