Table 4.
Risk Estimates for ≥ 7% Weight Gain With Atypical Antipsychotics Relative to Placebo in the Treatment of Bipolar Depression, Major Depressive Disorder, and Generalized Anxiety Disorder
| Antipsychotic | Diagnosis | Duration (wk) |
Treatment Armsa | No. of Patients, Total |
No. of Patients With ≥ 7% Weight Gain |
Absolute Risk Increase (%) | NNTH, Mean (95% CI) |
|
|---|---|---|---|---|---|---|---|---|
| Mean (95% CI) | Pearson P |
|||||||
| Bipolar depression | ||||||||
| Aripiprazole15 | Bipolar I depression | 8 | Aripiprazole 5–30 mg/d (15.5–17.6 mg/d) | 360 | 17 | 1.5 (−1.5 to ∞ to 4.5) | .317 | NS |
| Placebo | 367 | 12 | ||||||
| Olanzapine16 | Bipolar I depression | 8 | Olanzapine 5–20 mg/d (9.7 mg/d) | 347 | 65 | 18.5 (14.5 to 22.9) | <.0001 | 5 (4 to 7) |
| Olanzapine/fluoxetine combination | 82 | 16 | 19.2 (12.0 to 29.1) | <.0001 | 5 (3 to 8) | |||
| Placebo | 355 | 1 | ||||||
| Quetiapine-IR17–20 | Bipolar I or II depression | 8 | Quetiapine-IR 300 mg/d | 851 | 53 | 3.6 (1.4 to 5.7) | .0016 | 28 (18 to 71) |
| Quetiapine-IR 600 mg/d | 861 | 75 | 6.1 (3.7 to 8.4) | <.0001 | 17 (12 to 27) | |||
| Placebo | 602 | 16 | ||||||
| Quetiapine-XR21 | Bipolar I or II depression | 8 | Quetiapine-XR 300 mg/d | 137 | 11 | 7.3 (2.6 to 13.1) | .0027 | 14 (8 to 39) |
| Placebo | 140 | 1 | ||||||
| Major depressive disorder | ||||||||
| Aripiprazole22,23 | Refractory MDD | 6 | Aripiprazole 2–20 mg/d (11.0–11.8 mg/d) | 371 | 19 | 4.6 (1.3 to 7.3) | .0001 | 22 (14 to 44) |
| Placebo | 366 | 2 | ||||||
| Olanzapine24,b | Refractory MDD | 8 | Olanzapine 6–12 mg/d (8.5 mg/d) | 144 | 6 | 4.2 (0.7 to 8.8) | .0146 | 24 (11 to 141) |
| Olanzapine/fluoxetine (8.5/35.6 mg/d) | 146 | 11 | 7.5 (3.3 to 13.0) | .0009 | 13 (8 to 30) | |||
| Fluoxetine 25–50 mg/d (35.8 mg/d) | 142 | 0 | ||||||
| Quetiapine-XR26,27 | Refractory MDD | 6 | Quetiapine-XR 150 mg/d | 315 | 9 | 1.2 (−1.3 to ∞ to 3.9) | .296 | NS |
| Quetiapine-XR 300 mg/d | 312 | 18 | 4.2 (1.2 to 7.5) | .0061 | 24 (13 to 85) | |||
| Placebo | 309 | 5 | ||||||
| Quetiapine-XR28,29 | MDD | 6 | Quetiapine-XR 50 mg/d | 181 | 1 | 0.0 (−1.6 to ∞ to 2.5) | .9551 | NS |
| Quetiapine-XR 150 mg/d | 330 | 9 | 2.1 (0.1 to 4.6) | .0301 | 47 (22 to 773) | |||
| Quetiapine-XR 300 mg/d | 331 | 13 | 3.3 (1.1 to 6.1) | .0035 | 30 (17 to 91) | |||
| Placebo | 338 | 2 | ||||||
| Quetiapine-XR30 | MDD | 8 | Quetiapine-XR 150 or 300 mg/d | 152 | 2 | 0.0 (3.5 to ∞ to −3.5) | .9843 | NS |
| Placebo | 155 | 2 | ||||||
| Risperidone31 | Refractory MDD | 6 | Risperidone 1–2 mg/d | 137 | NA | |||
| Placebo | 131 | NA | ||||||
| Generalized anxiety disorder | ||||||||
| Quetiapine-XR32–34 | GAD | 8 | Quetiapine-XR 50 mg/d | 452 | 14 | 1.4 (0.4 to ∞ to −3.6) | .1112 | NS |
| Quetiapine-XR 150 mg/d | 673 | 29 | 2.6 (0.8 to 4.6) | .0044 | 38 (22 to 121) | |||
| Quetiapine-XR 300 mg/d | 441 | 18 | 2.4 (0.5 to 4.8) | .0137 | 41 (21 to 218) | |||
| Placebo | 663 | 11 | ||||||
| Quetiapine-XR35 | Refractory MDD | 8 | Quetiapine-XR 50–300 mg/d | 209 | 9 | 3 (0 to 7.1) | .0388 | 30 (14 to 3036) |
| Placebo | 200 | 2 | ||||||
a
Mean doses at study end are shown in parentheses.
b
≥ 10% weight gain was used in this study.
Abbreviations: GAD = generalized anxiety disorder, IR = immediate release, MDD = major depressive disorder, NA = not available, NNTH = number needed to treat to harm, NS = nonsignificant, XR = extended release.