Dear Editor:
Weight gain induced by atypical antipsychotics is a well known side effect.1 Among this group of medications, aripiprazole (Abilify®, Bristol Myers Squibb) has been reported to be weight neutral.2 We present here two cases that contradict this view.
A 15-year-old adolescent female subject was being treated for bipolar disorder. Aripiprazole was added to oxcarbazepine (Trileptal®, Novartis) for mood stabilization. The dose of aripirazole was increased to 10mg after one week. Two months later, the patient showed an increase in weight by 11kg. Aripirazole discontinuation was followed by loss of 2kg in the next four weeks.
An 11-year-old male subject was started on aripiprazole 5mg for aggressive behavior. The patient was also diagnosed with ADHD and was on methylphenidate HCl (Concerta®, McNeil Consumer & Specialty Pharmaceuticals) 36mg. After one month of aripiprazole, the patient gained 8kg. Aripiprazole was switched to ziprasidone HCI(Geodon®, Pfizer Inc.). The patient lost 3kg in four weeks on ziprasidone; however, due to continued concern about aggressive behavior, he was switched back to aripiprazole, and he again gained 9kg in a month.
Susceptibility to weight gain while on aripirazole was obvious in both of these patients. Most of the clinical trials have suggested that aripiprazole does not cause much weight gain. But we have to remember that most of these trials were done on an adult population. It is well known that children and adolescents can be more prone to weight gain as a side effect of atypical antipsychotics.2
Perhaps there is need for additional well-designed studies in the younger population to explore this further.
With regards,
Tanvir Singh, MD
Fellow in Child Psychiatry Medical College of Ohio Toledo, Ohio tsingh@mco.edu
References
- 1.Allison DB, Mentore JL, Heo M, et al. Antipsychotic-induced weight gain: A comprehensive research synthesis. Am J Psychiatry. 1999;156:1686–96. doi: 10.1176/ajp.156.11.1686. [DOI] [PubMed] [Google Scholar]
- 2.Stigler KA, Potenza MN, Posey DJ, McDougle CJ. Weight gain associated with atypical antipsychotics use in children and adolescents: Prevalence, clinical relevance, and management. Paediatr Drugs. 2004;6(1):33–44. doi: 10.2165/00148581-200406010-00003. [DOI] [PubMed] [Google Scholar]