Volume 4: No. 3, July 2007
LETTER TO THE EDITOR
Medical Treatment and Weight Gain
Suggested citation for this article: McGinn E. Medical treatment and weight gain
[letter to the editor]. Prev Chronic Dis [serial online] 2007
Jul [date cited]. Available from:
To the Editor:
“Addressing the Obesity Epidemic: A Genomics Perspective” in your April 2007
(1) issue speaks of the importance of considering all aspects of obesity.
However, one aspect overlooked in the article is weight gain associated
with medical treatment. Many classes of drugs are associated with weight gain
that leads to overweight or obesity; these include atypical antipsychotic drugs,
lithium, some antidepressant drugs, some antiepileptic drugs, and some steroids.
Other drugs are associated with fat redistribution (e.g., some drugs for
In addition to increasing weight, atypical antipsychotic drugs increase risk
for hyperglycemia (as noted in a black-box label required by the Food and Drug
Administration [FDA]), and they are associated with lipid dysregulation
(2). Atypical antipsychotic drugs induce excitation and hypomania or mania, adverse effects never reported for the older versions of typical antipsychotic drugs
(3). Some atypical antipsychotic drugs are also noncardiac QTc-interval–prolonging drugs and
are associated with increased sudden cardiac death
Atypical antipsychotic drugs are widely used off-label. The FDA issued a Public Health Advisory warning of a 60% to 70% increased risk for mortality among elderly people with dementia
being treated with atypical antipsychotic medications (5). From 1993 through
2002, prescriptions for atypical antipsychotic drugs for American children
increased 500% (all off-label);
85% of those prescriptions were for nonpsychotic conditions (6). The
public health implications of wide off-label use of this class of drugs merits more study.
Eileen McGinn, MPH
Hunter College of the City University of New York
Brookdale Center for Healthy Aging and Longevity
New York, NY
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- Newell A, Zlot
A, Silvey K, Ariail K.
Addressing the obesity epidemic: a genomics perspective. Prev Chronic Dis
[serial online] 2007 Apr.
- Newcomer JW. Metabolic considerations in the use of antipsychotic medications: a review of recent evidence. J Clin Psychiatry 2007;68 Suppl 1:20-7.
- Rachid F, Bertschy G, Bondolfi G, Aubry JM. Possible induction of mania or hypomania by atypical antipsychotics: an updated review of reported
cases. J Clin Psychiatry 2004 Nov;65(11):1537-45.
- Straus SM, Sturkenboom MC, Bleumink GS, Dieleman JP, van der
Lei J, de Graeff PA, et al. Non-cardiac QTc-prolonging drugs and the risk of sudden cardiac death. Eur Heart J 2005;26(19):2007-12.
- Public health advisory: deaths with antipsychotics in elderly patients with
behavioral disturbances. Rockville (MD): Food and Drug Administration; 2005.
- Olfson M, Blanco C, Liu L, Moreno C, Laje G. National trends in the outpatient treatment of children and adolescents with antipsychotic drugs. Arch Gen Psychiatry 2006;63(6):679-85.
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