An epidemiologic study of psychotropic medication and obesity-related chronic illnesses in older psychiatric patients

Kisely, Steve, Cox, Martha, Campbell, Leslie Anne, Cooke, Charmaine, Gardner, David and Quentin Rae-Grant (2009) An epidemiologic study of psychotropic medication and obesity-related chronic illnesses in older psychiatric patients. Canadian Journal of Psychiatry, 54 4: 269-274.

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Author Kisely, Steve
Cox, Martha
Campbell, Leslie Anne
Cooke, Charmaine
Gardner, David
Quentin Rae-Grant
Title An epidemiologic study of psychotropic medication and obesity-related chronic illnesses in older psychiatric patients
Journal name Canadian Journal of Psychiatry   Check publisher's open access policy
ISSN 0706-7437
Publication date 2009-04
Year available 2009
Sub-type Article (original research)
Open Access Status File (Publisher version)
Volume 54
Issue 4
Start page 269
End page 274
Total pages 6
Place of publication Ottowa, Canada
Publisher Canadian Psychiatric Association
Collection year 2010
Language eng
Subject 17 Psychology and Cognitive Sciences
Formatted abstract
Adverse effects from medication vary with age. Weight gain with several psychotropics is well
known in adults but less information is available related to extent and complications of
psychotropic-induced weight gain in older psychiatric patients. We determined the relative incidence of 2
obesity-related conditions (diabetes and hypertension) in older psychiatric patients receiving antipsychotics,
antidepressants, and mood stabilizers.


A population-based case–control study of all psychiatric patients aged 67 years or older in contact
with either specialist services or primary care using administrative data from Nova Scotia.


We identified incident cases of diabetes (n = 608) and of hypertension (n = 1056), as well as an
equal number of control subjects for each condition. Amitryptiline, selective serotonin reuptake inhibitors
(SSRIs), and olanzapine were associated with an increased risk of presenting with hypertension 6 months
after initial prescription. By contrast, conventional antipsychotics were associated with a reduced incidence
of hypertension. Olanzapine was also significantly associated with diabetes after 6 months (ORadj = 2.58,
95% CI 1.12 to 5.92). The findings for SSRIs and olanzapine remained significant after adjusting for
potential confounders such as sociodemographic characteristics, schizophrenia, beta blockers, thiazide
diuretics, and corticosteroids.


Our results suggest that the association of psychotropics and 2 obesity-related conditions,
hypertension and diabetes, applies to older psychiatric patients as well as younger populations. Within drug
classes, there are drugs that have a greater association than others, and this may be a factor when choosing a
specific agent.
Keyword Psychotropic Medication
Chronic Illnesses
Older Psychiatric Patients
psychotropic-induced weight
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: Queensland Centre for Health Data Services
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Created: Wed, 15 Jul 2009, 14:05:20 EST by Marisol da Silva on behalf of Faculty Of Health Sciences