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
1497-0015
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
C1
Formatted abstract
Objective:
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.

Method:

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.

Results:

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.

Conclusions:

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
Obesity-Related
Chronic Illnesses
Older Psychiatric Patients
psychotropic-induced weight
Seniors
obesity
psychotropics
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