도파민/세로토닌 길항성 비정형 항정신병약물로 치료 중인 정신분열병 환자에서 체중 증가의 관련 요인

• 영문명: Factors Related to Weight Gain in Patients with Schizophrenia Treated with Serotonin-Dopamine Antagonists
• 발행기관: 대한신경정신의학회
• 저자명: 김신겸 장원석 최경숙 박동연 한우상 이동수 홍경수
• 간행물 정보: 『신경정신의학』제43권 제3호, 303~311쪽, 전체 9쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 2004.05.30

영문 초록

Objectives：The purpose of this study was to investigate demographic, clinical, behavioral and metabolic-endocrine factors related to weight gain in patients with schizophrenia treated with serotonin-dopamine antagonists(SDA). Methods：Forty-two in-patients with DSM-IV schizophrenia were recruited from Samsung Seoul Hospital and St. Andrew Neuropsychiatric Hospital. The subjects were first-episode patients or patients who did not take any antipsychotics for the previous two months. All the patients were administered with one of the SDAs for 8 weeks. Body weights and body mass index (BMI) were measured weekly during the treatment period. The mean levels of daytime activities were evaluated at baseline and 4 weeks and 8 weeks after the treatment. To assess the clinical response to the medication, the Krawiecka Rating Scale (KRS) and Clinical Global Impression (CGI) were applied before and after the treatment. Fasting blood levels of glucose, cholesterol, triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL), and serum level of prolactin were measured before and after the treatment. Results：The body weight and BMI were significantly increased through the treatment periods. There were significant increases in the blood levels of cholesterol, TG and prolactin after 8 weeks. KRS total score showed significant decrease and the mean level of daytime activities showed significant increase by the treatment. Significant negative correlations were observed between the weight gain indices and the baseline BMI. The level of clinical improvement was significantly correlated with the degree of weight gain. Gender, age, smoking, daily dosages of antipsychotics, level of daytime activity and changes in appetite did not show any association with the weight gain indices. Neither the baseline biochemical variables nor their changes after the treatment were significantly correlated with the indices of weight gain. Conclusion：This result implies that low baseline BMI could be a risk factor of weight gain in short-term treatment of schizophrenia with SDAs. And it is also suggested that the effects of SDAs on weight gain and the clinical improvement might be developed through the same pharmacodynamic pathway.

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키워드

Schizophrenia Dopamine-serotonin antagonist Weight gain