Nervenheilkunde 2011; 30(09): 707-712
DOI: 10.1055/s-0038-1628415
Originalarbeit
Schattauer GmbH

Valproate- and comedication-induced change of weight associated with bipolar disorder

Artikel in mehreren Sprachen: deutsch | English
L. Hermle
1   Klinik für Psychiatrie und Psychotherapie, Christophsbad Göppingen
,
M. Simon
1   Klinik für Psychiatrie und Psychotherapie, Christophsbad Göppingen
,
K. Mey
1   Klinik für Psychiatrie und Psychotherapie, Christophsbad Göppingen
,
W. Hewer
2   Klinik für Gerontopsychiatrie und -psychotherapie, Vizenz von Paul Hospital, Rottweil am Neckar
,
T. Fett-Hamperl
1   Klinik für Psychiatrie und Psychotherapie, Christophsbad Göppingen
› Institutsangaben
Weitere Informationen

Publikationsverlauf

eingegangen am: 07. März 2011

angenommen am: 04. Mai 2011

Publikationsdatum:
23. Januar 2018 (online)

Summary

Objective: Aim of the study was the prospective examination of change of body weight and various metabolic syndrome-associated parameters in patients with bipolar spectrum disorders under first-line treatment with Valproate and other defined psychotropic comedication. Methods: Over a nine month period, body mass index (BMI), waist hip ratio (WHR), relative adipose tissue and blood lep-tin levels were measured at regular intervals in 14 patients treated with valproate and defined psychopharmacological agents. Results: Accordant with former studies the fat-cell derived hormone leptin correlated significantly with BMI, WHR and with the percental adipose issue. Conclusions: Initially all patients displayed abdominal obesity with increased BMI and WHR. During the nine month course of first-time valproate treatment no overall significant weight gain was recorded in these patients. In particular, no correlation was found between valproate-medication and the weight parameters tested. Psychotropic drug-induced change of weight is a frequent adverse side effect during treatment of bipolar patients. Our findings suggest that in patients undergoing psychopharmacological treatment there is an increased prevalence of metabolic syndrome-associated pathology of abdominal obesity. Further studies are required to corroborate the results.

 
  • Literatur

  • 1 AWMF-Leitlinie Adipositas der Deutschen Adipositas Gesellschaft. Deutsche Diabetes Gesellschaft, der Deutschen Gesellschaft für Ernährung. Univ. Düsseldorf. 2003
  • 2 Drieling T, Biedermann NC, Schärer N, Strobl N, Langosch JM. Gewichtsveränderungen unter Therapie mit Psychopharmaka. Fortschr Neurol Psychiat 2007; 75: 65-80.
  • 3 Kraus T, Haack M, Schuld A, Hinze-Selch D, Koethe D, Pollmächer T. Zur Pathophysiologie der Gewichtsregulation im Rahmen der Therapie mit Psychopharmaka. Fortsch Neurol Psychiat 2001; 69: 116-137.
  • 4 National Cholesterol Education Program (NCEP): Third report of the expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (ATP III Final Report). NIH Publication No. 02–5215, September 2002. www.nhlbi.nih.gov/guidelines/cholesterol/atp3_rpt.htm
  • 5 National Heart, Lung and Blood Institute/National Instituts of Diabetes and Digestive and Kidney Diseases. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. The Evidence Report. Bethesta: National Institutes of Health; 1998
  • 6 Flegal KM, Carrol MD, Ogden CL. et al. Prevalence and trends in obesity among US adults. JAMA 2002; 288: 1723-1727.
  • 7 Bowden CL, Calabrese JR, McElroy SL. et al. A randomized, placebo-controlled 12-month trial of divalproex and lithium in treatment of outpatients with bipolar disorder. Arch Gen Psychiatry 2000; 57: 481-489.
  • 8 Grunze H, Walden J. Bipolare affektive Störungen. 3. Auflage. Stuttgart: Thieme; 2003
  • 9 Calabrese JR, Goethe JW, Kayser A. et al. Adverse events in 583 valproate-treated patients. Depression 1995; 03: 257-262.
  • 10 Grunze H, Walden J. Bipolare affektive Störungen. 3. Auflage. Stuttgart: Thieme; 2003
  • 11 Tohen M. et al. Olanzapine versus divalproex sodium for the treatment of acute mania and maintenance of remission: a 47-week study. Am J Psychiatry 2003; 160: 1263-1271.
  • 12 Grunze H. Valproinsäure bei bipolaren Störungen. Psychopharmakotherapie 2007; 14: 47-64.
  • 13 Corman CL, Leung NM, Guberman AH. Weight gain in epileptic patients during treatment with valproic acid: a retrospective study. Can J Neurol Sci 1997; 24: 240-244.
  • 14 Isojärvi Ji, Laatikainen TJ, Pakarinen AJ. Obesity and endocrine disorder in women taking valproate for epilepsy. Ann Neurol 1996; 39: 579-584.
  • 15 Biton V, Mirza W, Vuong A, Hammer AE, Barret PS. Weight change associated with valproate and lamotigine monotherapy in patients with epilepsy. Neurology 2001; 56: 172-177.
  • 16 Mattson RH, Cramer JA, Collins JF. A comparison of valproate with carbamazepin for the treatment of complex parial seizures and secondarily generalized tonic-clonic seizures in adults. The Department of Veterans Affairs Epilepsy Cooperative Study. No. 264. N Engl J Med 1992; 327: 765-771.
  • 17 Dinesen H, Gram L, Veje A. Weight gain during treatment with valproate. Acta Neurol Scand 1984; 70: 65-69.
  • 18 Allison DB. et al. Antipsychotic-Induced Weight Gain: A Comprehensive Research Synthesis. Am J Psychiatry 1999; 156: 1686-1696.
  • 19 Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Brit J Psychiatry 1978; 133: 429-35.
  • 20 Depres JP, Lemieux I, Prud’homme D. Treatment of obesity: needs to focus on high risk abdominally obese patients. BMJ 2001; 322: 716-720.
  • 21 Schafroth U, Godang K, Ueland T, Bollerslev J. Leptin response to endogenous acute stress is independent of pituitary function. Eur J Endocrinol 2001; 145: 295-301.
  • 22 Müller DJ. et al. Genetik der Antipsychotika-assoziierten Gewichtszunahme. Nervenarzt 2009; 80: 556-563.
  • 23 Pollmächer T. Leptin und psychiatrische Erkrankungen. Nervenarzt 2002; 73: 897-902.
  • 24 Verotti A, Basciani F, Morresi S, deMartino M, Morgese G, Chiarelli F. Serum leptin changes in epileptic patients who gain weight after therapy with valproic acid. Neurology 1999; 53: 230-232.
  • 25 McIntyre RS, Soczcynska JK, Beyer JL. et al. Medical comorbidity in bipolar disorders: reprioritizing unmet needs. Curr Opin Psychiatry 2007; 20: 406-416.
  • 26 Ösby U, Brandt L, Correia N. et al. Excess mortality in bipolar and unipolar disorder in Sweden. Arch Gen Psychiatry 2001; 58: 844-850.