Effects of antipsychotics on fat deposition and changes in leptin and insulin levels. Magnetic resonance imaging study of previously untreated people with schizophrenia

Br J Psychiatry. 2004 Jan:184:58-62. doi: 10.1192/bjp.184.1.58.

Abstract

Background: Weight gain is a common consequence of antipsychotic drug treatment and can lead to further morbidity.

Aims: To assess the effects of antipsychotic drug therapy on abdominal fat deposition, on insulin and leptin secretion, and on circulating glucose and lipids.

Method: Abdominal body fat was determined by magnetic resonance imaging in a group of previously untreated patients with schizophrenia, before and after 10 weeks' antipsychotic drug treatment. Body mass and blood concentrations of glucose, insulin, leptin and lipids were also measured.

Results: Significant increases in both subcutaneous and intra-abdominal fat were identified after antipsychotic drug treatment. A three-fold increase in leptin secretion as well as significant increases in levels of circulating lipids and non-fasting glucose were also identified.

Conclusions: Patients first receiving antipsychotic drugs experience substantial deposition of both subcutaneous and intra-abdominal fat, reflecting a loss of the normal inhibitory control of leptin on body mass. Along with fat deposition, the increase in levels of fasting lipids and in non-fasting glucose may provide early signs of drug-induced progression towards the metabolic syndrome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdomen / pathology
  • Adipose Tissue / drug effects*
  • Adipose Tissue / pathology
  • Adult
  • Antipsychotic Agents / pharmacology*
  • Blood Glucose / drug effects
  • Blood Glucose / metabolism
  • Body Constitution
  • Female
  • Humans
  • Insulin / blood*
  • Leptin / blood*
  • Magnetic Resonance Imaging
  • Male
  • Schizophrenia / blood
  • Schizophrenia / drug therapy*
  • Schizophrenia / pathology
  • Sex Factors
  • Treatment Outcome
  • Weight Gain / drug effects

Substances

  • Antipsychotic Agents
  • Blood Glucose
  • Insulin
  • Leptin