Schoretsanitis, Georgios; https://orcid.org/0000-0002-3851-4117, Dubath, Céline, Grosu, Claire, Piras, Marianna, Laaboub, Nermine, Ranjbar, Setareh, Ansermot, Nicolas, Crettol, Séverine; https://orcid.org/0000-0003-3790-7194, Vandenberghe, Frederik, Gamma, Franziska, von Gunten, Armin, Plessen, Kerstin Jessica, Seifritz, Erich; https://orcid.org/0000-0002-7311-4426, Conus, Philippe, Eap, Chin B; https://orcid.org/0000-0002-5439-0230, Schoretsanitis, Georgios; https://orcid.org/0000-0002-3851-4117, Dubath, Céline, Grosu, Claire, Piras, Marianna, Laaboub, Nermine, Ranjbar, Setareh, Ansermot, Nicolas, Crettol, Séverine; https://orcid.org/0000-0003-3790-7194, Vandenberghe, Frederik, Gamma, Franziska, von Gunten, Armin, Plessen, Kerstin Jessica, Seifritz, Erich; https://orcid.org/0000-0002-7311-4426, Conus, Philippe, and Eap, Chin B; https://orcid.org/0000-0002-5439-0230
Metabolic abnormalities have been associated with olanzapine treatment. We assessed if olanzapine has dose-dependent effects on metabolic parameters with changes for weight, blood pressure, lipid and glucose profiles being modelled using linear mixed-effects models. The risk of metabolic abnormalities including early weight gain (EWG) (≥5% during first month) was assessed using mixed-effects logistic regression models. In 392 olanzapine-treated patients (median age 38.0 years, interquartile range [IQR] = 26.0-53.3, median dose 10.0 mg/day, IQR = 5.0-10.0 for a median follow-up duration of 40.0 days, IQR = 20.7-112.2), weight gain was not associated with olanzapine dose (p = 0.61) although it was larger for doses versus ≤10 mg/day (2.54 ± 5.55 vs. 1.61 ± 4.51% respectively, p = 0.01). Treatment duration and co-prescription of >2 antipsychotics, antidepressants, benzodiazepines and/or antihypertensive agents were associated with larger weight gain (p < 0.05). Lower doses were associated with increase in total and HDL cholesterol and systolic and diastolic blood pressure (p < 0.05), whereas higher doses were associated with glucose increases (p = 0.01). Patients receiving >10 mg/day were at higher EWG risk (odds risk: 2.15, 1.57-2.97). EWG might be prominent in high-dose olanzapine-treated patients with treatment duration and co-prescription of other medications being weight gain moderators. The lack of major dose-dependent patterns for weight gain emphasizes that olanzapine-treated patients are at weight gain risk regardless of the dose.