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Oral use - olanzapine wafer reduces weight gain side effects

Discussion in 'Antipsychotics' started by lostmente, Jul 21, 2009.

  1. lostmente

    lostmente Silver Member

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    apparently olanzapine will act on receptors in the stomach and this greatly contributes to the increased cravings for carbohydrates that is suspected to be the main cause of olanzapine weight gain

    with the zydis wafer, no olanzapine can affect the stomach receptors

    this was explained to swim by a psyche nurse. any one seen any back up information?
     
  2. r0ssi

    r0ssi Newbie

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    In personal experience, yes the wafer does get rid of hunger cravings, but does not slow down the metabolism!
    Be careful, after swim changed to the wafer and meals where all corrected, the food still wasnt staying in the body for more 12 hours! Swim lost all his weight he had put on during his psychosis treatment, so basically, swim is back to the skinny dope smoker look he was prior to psychosis
     
  3. lostmente

    lostmente Silver Member

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    swim is on respiridone now, do not know if a similiar result is expected
     
  4. SamanthaRabbit

    SamanthaRabbit Silver Member

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    I have been prescribed olanzapine wafers and in no way shape or form did they reduce weight gain side effects. I gained 45lbs in 3 and a half months of being on the wafers.

    I am not a medical professional but I believe that this is misinformation to say that the wafers cause less weight gain side effects.

    In my experience I went from having severe anxiety that inhibited my appetite and over the course of about 8 or so months I dropped down to almost 100lbs, and ranged from 100-105lbs for a matter of months. When the weight loss from anxiety happened and the daily anxiety effects started to happen I went to see a nurse practitioner who specializes in psychiatric medication and she prescribed me Zyprexa. After starting this medication it brought out a serious food addiction in me, and I went from being unable to gain weight to being slowed down and having food cravings 24/7 but especially after I would take my Zyprexa. On top of having issues with having cravings and being hungry all the time, my medications were so expensive that it was extremely hard to buy the right, healthy foods. I gained 40lbs over about 3 months and then after a change in lifestyle I was able to cut down the gain to only being about 8lbs in 2 months.

    Now that I have gone off the Zyprexa I am not having issues with weight gain, but for these first few days I have been suffering from lack of appetite again.
     
    Last edited: Oct 13, 2010
  5. Mindless

    Mindless Gold Member

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    [FONT=Verdana, sans-serif]The mechanism behind antipsychotic weight gain might not be the same in every case, and does not seem to be fully understood. Most if not all antipsychotics have the potential to cause weight gain. [/FONT]Individuals have varying risk factors for obesity, so that Olanzapine may cause weight gain in some but not in others. I can find no evidence that 'orodispersible' formulations are less likely to cause weight gain. As far as I can tell the only advantage of this preparation is that it renders Olanzapine water soluble. According to the [FONT=Verdana, sans-serif]Medicines and Healthcare products Regulatory Agency (UK)[/FONT], weight gain is 'very common' with orodispersible Olanzapine. Olanzapine 'commonly induces weight gain' in all it's formulations. (British National Formulary 63 2012).

    One study found that 'Orally disintegrating olanzapine induces less weight gain in adolescents than standard oral tablets' (Crocq et al, 2007). However, the study also found that weight gain remains an issue with orodispersible Olanzapine; 'OLZ ODT treatment was associated with significantly greater increases in weight and BMI than risperidone (1.0+/-1.8 kg; 0.4+/-0.7 kg/m(2))'. Crocq et al suggest that orodispersible olanzapine ('OLZ ODT') 'shortens the time of interaction with digestive serotonin receptors mediating satiety'. Adolescents may gain less weight with orodispersible olanzapine, but weight gain remains a problem. I'm not sure how appropriate it is to treat adolescents with antipsychotics, but that's probably off-topic.

    [FONT=Verdana, sans-serif]Serotonin, dopamine, andrenaline, histamine, and cannabinoid receptors and signalling have been proposed as mechanisms behind antipsychotic weight gain. Anticholinergic induced dry mouth has also been considered a possible cause, since it may lead to increased consumption of high calorie drinks (Deng et al, 2007).[FONT=Verdana, sans-serif][FONT=Verdana, sans-serif] Dwyer and Donohoe (2003) found that 'clozapine, desmethylclozapine, [/FONT][/FONT]quetiapine, [FONT=Verdana, sans-serif][FONT=Verdana, sans-serif]and loxapine, and the original antipsychotic, chlorpromazine, induced significant hyperglycemia in the mice in accordance with their effects on glucose transport.'[/FONT][/FONT][/FONT]

    [FONT=Verdana, sans-serif]Neuropeptides look like good candidates in accounting for antipsychotic weight gain. Insulin, leptin, and other neuropeptide signaling might have an impact on appetite and weight gain. Leptin and insulin may regulate food intake and energy balance, 'antipsychotics could induce or exacerbate a leptin-resistance status. Resistance to leptin could generate metabolic conditions resulting in weight gain' (Panariello et al 2005).[/FONT] [FONT=Verdana, sans-serif]The peptide ghrelin may stimulate appetite. Murashita et al (2005) suggest that ghrelin secretion may be increased by Olanzapine, leading to increased appetite and weight gain. [FONT=Verdana, sans-serif]Histamine antagonists such as H1 may increase the activation of AMP-kinase, an appetite regulating enzyme (Kim et al 2007).[/FONT][/FONT][FONT=Verdana, sans-serif]

    There are genetic polymorphisms and other indications of risk of weight gain in all of us, which exist independently of antipsychotic use. These risk markers bear consideration when choosing medications, and in taking steps to prevent or minimise weight gain, such as metabolic monitoring. Antipsychotic weight gain and obesity can shorten lives and is associated with illnesses such as diabetes, it's negative effects should not be underestimated. Panariello et al advocate personalised medicine and more research on the metabolic impact of antipsychotics:
    [/FONT]

    “[FONT=Verdana, sans-serif]As psychiatric practice moves into an era of personalized medicine, the ability to identify risk markers, besides those related to demographic characteristics or the drug itself, will not only help clinicians to screen out patients at high risk for weight gain and metabolic changes, but potentially allow earlier access to higher-risk medications for patients who do not possess vulnerability markers. Medications such as olanzapine and clozapine carry significant metabolic burdens, but are effective treatments for some patients who do not respond to other antipsychotics. The elucidation of mechanisms by which antipsychotic medications impact metabolic parameters remains important for quantification of patient risk, to inform the frequency and targets of metabolic monitoring during antipsychotic therapy, and to permit the development of novel agents without these limitations.”[/FONT]

    [FONT=Verdana, sans-serif]Sources:[/FONT]
    [FONT=Verdana, sans-serif]Weight Gain, Schizophrenia and Antipsychotics: New Findings from Animal Model and Pharmacogenomic Studies. Fabio Panariello et al, Schizophrenia Research and Treatment 2011.[/FONT]
    [FONT=Verdana, sans-serif]The Role of Leptin in Antipsychotic-Induced Weight Gain: Genetic and Non-Genetic Factors. Fabio Panariello et al, January 2005.[/FONT]
    [FONT=Verdana, sans-serif]Olanzapine increases plasma ghrelin level in patients with schizophrenia. [/FONT][FONT=Verdana, sans-serif]Murashita M et al, [/FONT][FONT=Verdana, sans-serif]Psychoneuroendocrinology.[/FONT][FONT=Verdana, sans-serif] 2005 Jan;30(1):106-10.[/FONT]
    [FONT=Verdana, sans-serif]Antipsychotic drug-induced weight gain mediated by histamine H1 receptor-linked activation of hypothalamic AMP-kinase. [/FONT][FONT=Verdana, sans-serif]Kim et al, [/FONT][FONT=Verdana, sans-serif]PNAS Early Edition[/FONT][FONT=Verdana, sans-serif], 2/9/07. [/FONT]
    [FONT=Verdana, sans-serif]Induction of hyperglycemia in mice with atypical antipsychotic drugs that inhibit glucose uptake. Dwyer D, Donohoe D, Pharmacology Biochemistry and Behaviour 2003.[/FONT]
    [FONT=Verdana, sans-serif]Olanazpine 5mg, 10mg and 15mg Orodispersible tablets. Medicines and Healthcare products Regulatory Agency (UK) 2011.
    British National Formulary 63, March 2012.
    [/FONT]
    Orally disintegrating olanzapine induces less weight gain in adolescents than standard oral tablets. Crocq et al, Eur Psychiatry. 2007 Oct;22(7):453-4. Epub 2007 Aug 30.
     
    Last edited: Oct 8, 2012