20 results on '"Psychotropic Drugs/adverse effects"'
Search Results
2. Use of psychotropic medication and risk of road traffic crashes: a registry-based case–control study in Denmark, 1996–2018
- Author
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Anne Vingaard Olesen, Tanja Kidholm Osmann Madsen, Harry Lahrmann, and Jimmi Nielsen
- Subjects
DISORDER ,Automobile Driving ,PSYCHOMOTOR FUNCTION ,Case–control study ,IMPACT ,Denmark ,Benzodiazepines/adverse effects ,Psychotropic Drugs/adverse effects ,Road traffic crash ,ACCIDENTS ,Benzodiazepines ,Hypnotics and Sedatives ,ADHD ,DRUGS ,Registries ,Pharmacology ,Psychotropic Drugs ,Psychotropic medication ,Accidents, Traffic ,Case-control study ,ADULTS ,ANTIDEPRESSANTS ,Denmark/epidemiology ,Case-Control Studies ,Automobile Driving/psychology ,human activities ,DRIVING PERFORMANCE - Abstract
Rationale Use of psychotropics is relatively prevalent amongst motor vehicle drivers because mobility is also important for persons suffering from psychiatric illness. However, medication side effects may increase the likelihood of being involved in traffic crashes. Objectives This study aimed to assess the association between the use of four types of medication (antipsychotics, benzodiazepines and z-hypnotics, antidepressants and stimulants of ADHD treatment) and the risk of traffic crashes, in general, and single crashes subsequently. Method We conducted a case–control study of data from 130,000 drivers involved in traffic crashes with personal injury and prescription data from all of Denmark during the period 1996–2018. Results For antipsychotics, we found odds ratios of 0.86 and 1.29 for traffic crashes and single crashes, respectively; for benzodiazepines and z-hypnotics, 1.29 and 2.49, respectively; for antidepressants, 1.30 and 2.25, respectively; and for stimulants of ADHD treatment, 1.62 and 1.95, respectively. All p values were below 0.001. Conclusions Based on our results on twofold increased risks of single crashes and moderately increased risks in persons with ADHD, it might seem tempting to ban psychotropic medication in traffic. Conversely, we accept increased risks of traffic crashes in young drivers and in the physically disabled with special aids and, to some extent, with exposure to alcohol. In the end, it is the authorities who must review the evidence and decide whether to prohibit (some types of) psychotropic medication in traffic. Finally, underlying disease and not the drug may increase the risk of being involved in a traffic crash.
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- 2022
3. Evolutions of Metabolic Parameters Following Switches of Psychotropic Drugs: A Longitudinal Cohort Study
- Author
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Marianna Piras, Setareh Ranjbar, Nermine Laaboub, Claire Grosu, Franziska Gamma, Kerstin Jessica Plessen, Armin von Gunten, Philippe Conus, and Chin Bin Eap
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Psychiatry and Mental health ,Humans ,Longitudinal Studies ,Psychotropic Drugs/adverse effects ,Weight Gain ,Cohort Studies ,Weight Loss ,metabolic risk ,psychotropic switch ,weight gain - Abstract
Background Several psychotropic drugs can induce weight gain and metabolic alterations. The authors compared metabolic evolutions of patients switching versus continuing psychotropic treatments with different risk profiles. Methods Patients either switched from a high- to a medium- (N = 36) or low-risk drug (N = 27), from a medium- to a low-risk drug (N = 71), or to a same-risk drug (N = 61). Controls were kept using either a high- (N = 35), medium- (N = 155), or low-risk drug (N = 47). The evolution over 2 years of weight and metabolic parameters was analyzed using linear mixed-effect models, also examining the influence of polygenic risk scores for body mass index (BMI) or BMI and psychiatric disorders. Study Results High-, medium-, or low-risk controls gained on average 1.32%, 0.42%, and 0.36% more weight per month than patients switching from or within these risk categories (P Conclusion Psychotropic switches to a lower- or same-risk drug can attenuate weight gain, with only switching high to low resulting in weight loss.
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- 2022
4. Use of psychotropic medication and risk of road traffic crashes:a registry-based case-control study in Denmark, 1996-2018
- Author
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Olesen, Anne Vingaard, Madsen, Tanja Kidholm Osmann, Lahrmann, Harry, and Nielsen, Jimmi
- Subjects
Psychotropic medication ,Case–control study ,Case-Control Studies ,Automobile Driving/psychology ,Accidents, Traffic ,Hypnotics and Sedatives ,Benzodiazepines/adverse effects ,Registries ,Psychotropic Drugs/adverse effects ,Road traffic crash ,Denmark/epidemiology - Abstract
Rationale: Use of psychotropics is relatively prevalent amongst motor vehicle drivers because mobility is also important for persons suffering from psychiatric illness. However, medication side effects may increase the likelihood of being involved in traffic crashes. Objectives: This study aimed to assess the association between the use of four types of medication (antipsychotics, benzodiazepines and z-hypnotics, antidepressants and stimulants of ADHD treatment) and the risk of traffic crashes, in general, and single crashes subsequently. Method: We conducted a case–control study of data from 130,000 drivers involved in traffic crashes with personal injury and prescription data from all of Denmark during the period 1996–2018. Results: For antipsychotics, we found odds ratios of 0.86 and 1.29 for traffic crashes and single crashes, respectively; for benzodiazepines and z-hypnotics, 1.29 and 2.49, respectively; for antidepressants, 1.30 and 2.25, respectively; and for stimulants of ADHD treatment, 1.62 and 1.95, respectively. All p values were below 0.001. Conclusions: Based on our results on twofold increased risks of single crashes and moderately increased risks in persons with ADHD, it might seem tempting to ban psychotropic medication in traffic. Conversely, we accept increased risks of traffic crashes in young drivers and in the physically disabled with special aids and, to some extent, with exposure to alcohol. In the end, it is the authorities who must review the evidence and decide whether to prohibit (some types of) psychotropic medication in traffic. Finally, underlying disease and not the drug may increase the risk of being involved in a traffic crash.
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- 2022
5. Mental Health Among Patients with non-Hodgkin Lymphoma:a Danish Nationwide Study of Psychotropic Drug Use in 8,750Patients and 43,750 Matched Comparators
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Andreas Kiesbye Øvlisen, Lasse Hjort Jakobsen, Kristian Hay Kragholm, René Ernst Nielsen, Peter de Nully Brown, Rasmus Bo Dahl‐Sørensen, Henrik Frederiksen, Nikolaj Mannering, Pär Lars Josefsson, Ahmed Ludvigsen Al‐Mashhadi, Judit Mészáros Jørgensen, Andriette Dessau‐Arp, Michael Roost Clausen, Robert Schou Pedersen, Christian Torp‐Pedersen, Marianne Tang Severinsen, and Tarec Christoffer El‐Galaly
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Male ,Denmark ,CANCER-PATIENTS ,CIVIL REGISTRATION SYSTEM ,Psychotropic Drugs/adverse effects ,DIAGNOSIS ,Cohort Studies ,DISTRESS ,immune system diseases ,hemic and lymphatic diseases ,ANXIETY ,Humans ,COHORT ,Prospective Studies ,Lymphoma, Non-Hodgkin/complications ,Aged ,RISK ,Psychotropic Drugs ,Lymphoma, Non-Hodgkin ,B-CELL LYMPHOMA ,Hematology ,DEPRESSION ,Denmark/epidemiology ,PREVALENCE ,Mental Health ,Female - Abstract
Psychological distress following cancer diagnosis may lead to mental health complications including depression and anxiety. Non-Hodgkin lymphomas (NHLs) include indolent and aggressive subtypes for which treatment and prognosis differ widely. Incident use of psychotropic drugs (PDs - antidepressants, antipsychotics, and anxiolytics) and its correlation to lymphoma types can give insights into the psychological distress these patients endure. In this prospective matched cohort study, we used nationwide population-based registries to investigate the cumulative risk of PD use in NHL patients compared to a sex- and age-matched cohort from the Danish background population. In addition, contact patterns to psychiatric departments and incident intentional self-harm or completed suicide were explored. In total, 8,750 NHL patients and 43,750 matched comparators were included (median age 68; male:female ratio 1.6). Median follow-up was 7.1 years. Two-year cumulative risk of PD use was higher in NHL patients (16.4%) as compared to the matched comparators (5.1%, p
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- 2022
6. Insomnia disorders are associated with increased cardiometabolic disturbances and death risks from cardiovascular diseases in psychiatric patients treated with weight-gain-inducing psychotropic drugs: results from a Swiss cohort
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Laaboub, N., Dubath, C., Ranjbar, S., Sibailly, G., Grosu, C., Piras, M., Délessert, D., Richard-Lepouriel, H., Ansermot, N., Crettol, S., Vandenberghe, F., Grandjean, C., Delacrétaz, A., Gamma, F., Plessen, K.J., von Gunten, A., Conus, P., and Eap, C.B.
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Cardiovascular Diseases/chemically induced ,Cardiovascular Diseases/epidemiology ,Female ,Humans ,Male ,Metabolic Syndrome/chemically induced ,Metabolic Syndrome/complications ,Metabolic Syndrome/epidemiology ,Prospective Studies ,Psychotropic Drugs/adverse effects ,Sleep Initiation and Maintenance Disorders ,Switzerland/epidemiology ,Weight Gain ,Cardiovascular diseases ,Insomnia disorders ,Metabolic syndrome ,Metabolic worsening ,Psychiatry - Abstract
Insomnia disorders as well as cardiometabolic disorders are highly prevalent in the psychiatric population compared to the general population. We aimed to investigate their association and evolution over time in a Swiss psychiatric cohort. Data for 2861 patients (8954 observations) were obtained from two prospective cohorts (PsyMetab and PsyClin) with metabolic parameters monitored routinely during psychotropic treatment. Insomnia disorders were based on the presence of ICD-10 "F51.0" diagnosis (non-organic insomnia), the prescription of sedatives before bedtime or the discharge letter. Metabolic syndrome was defined using the International Diabetes Federation definition, while the 10-year risk of cardiovascular event or death was assessed using the Framingham Risk Score and the Systematic Coronary Risk Estimation, respectively. Insomnia disorders were observed in 30% of the cohort, who were older, predominantly female, used more psychotropic drugs carrying risk of high weight gain (olanzapine, clozapine, valproate) and were more prone to suffer from schizoaffective or bipolar disorders. Multivariate analyses showed that patients with high body mass index (OR = 2.02, 95%CI [1.51-2.72] for each ten-kg/m 2 increase), central obesity (OR = 2.20, [1.63-2.96]), hypertension (OR = 1.86, [1.23-2.81]), hyperglycemia (OR = 3.70, [2.16-6.33]), high density lipoprotein hypocholesterolemia in women (OR = 1.51, [1.17-1.95]), metabolic syndrome (OR = 1.84, [1.16-2.92]) and higher 10-year risk of death from cardiovascular diseases (OR = 1.34, [1.17-1.53]) were more likely to have insomnia disorders. Time and insomnia disorders were associated with a deterioration of cardiometabolic parameters. Insomnia disorders are significantly associated with metabolic worsening and risk of death from cardiovascular diseases in psychiatric patients.
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- 2022
7. Relation of severe COVID-19 to polypharmacy and prescribing of psychotropic drugs:the REACT-SCOT case-control study
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Paul M. McKeigue, Sharon Kennedy, Amanda Weir, Jen Bishop, Stuart J. McGurnaghan, David McAllister, Chris Robertson, Rachael Wood, Nazir Lone, Janet Murray, Thomas M. Caparrotta, Alison Smith-Palmer, David Goldberg, Jim McMenamin, Bruce Guthrie, Sharon Hutchinson, Helen M. Colhoun, and on behalf of Public Health Scotland COVID-19 Health Protection Study Group
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Male ,Antipsychotic agents ,Proton pump inhibitors ,lcsh:Medicine ,Comorbidity ,Psychotropic Drugs/adverse effects ,Rate ratio ,Gabapentinoids ,Severity of Illness Index ,0302 clinical medicine ,Overprescribing ,Medicine ,030212 general & internal medicine ,media_common ,Aged, 80 and over ,education.field_of_study ,General Medicine ,Pharmacoepidemiology ,Middle Aged ,Female ,Research Article ,Drug ,medicine.medical_specialty ,Scotland/epidemiology ,Critical Care ,media_common.quotation_subject ,Population ,Drug Prescriptions ,RS ,03 medical and health sciences ,Internal medicine ,Severity of illness ,Humans ,Medical prescription ,education ,Aged ,Polypharmacy ,Psychotropic Drugs ,COVID-19/chemically induced ,Dose-Response Relationship, Drug ,business.industry ,lcsh:R ,COVID-19 ,medicine.disease ,Opioids ,Scotland ,Case-Control Studies ,business ,030217 neurology & neurosurgery ,Critical Care/trends - Abstract
Background The objective of this study was to investigate the relation of severe COVID-19 to prior drug prescribing. Methods Severe cases were defined by entry to critical care or fatal outcome. For this matched case-control study (REACT-SCOT), all 4251 cases of severe COVID-19 in Scotland since the start of the epidemic were matched for age, sex and primary care practice to 36,738 controls from the population register. Records were linked to hospital discharges since June 2015 and dispensed prescriptions issued in primary care during the last 240 days. Results Severe COVID-19 was strongly associated with the number of non-cardiovascular drug classes dispensed. This association was strongest in those not resident in a care home, in whom the rate ratio (95% CI) associated with dispensing of 12 or more drug classes versus none was 10.8 (8.8, 13.3), and in those without any of the conditions designated as conferring increased risk of COVID-19. Of 17 drug classes postulated at the start of the epidemic to be “medications compromising COVID”, all were associated with increased risk of severe COVID-19 and these associations were present in those without any of the designated risk conditions. The fraction of cases in the population attributable to exposure to these drug classes was 38%. The largest effect was for antipsychotic agents: rate ratio 4.18 (3.42, 5.11). Other drug classes with large effects included proton pump inhibitors (rate ratio 2.20 (1.72, 2.83) for = 2 defined daily doses/day), opioids (3.66 (2.68, 5.01) for = 50 mg morphine equivalent/day) and gabapentinoids. These associations persisted after adjusting for covariates and were stronger with recent than with non-recent exposure. Conclusions Severe COVID-19 is associated with polypharmacy and with drugs that cause sedation, respiratory depression, or dyskinesia; have anticholinergic effects; or affect the gastrointestinal system. These associations are not easily explained by co-morbidity. Measures to reduce the burden of mortality and morbidity from COVID-19 should include reinforcing existing guidance on reducing overprescribing of these drug classes and limiting inappropriate polypharmacy. Registration ENCEPP number https://EUPAS35558
- Published
- 2021
8. Evaluation of Cardiometabolic Risk in a Large Psychiatric Cohort and Comparison With a Population-Based Sample in Switzerland
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Aurélie Delacrétaz, Céline Dubath, Hélène Richard-Lepouriel, Roland Hasler, Anaïs Glatard, Peter Vollenweider, Sylfa Fassassi, Jacques Thonney, Chin B. Eap, Alessandra Solida, Armin von Gunten, Philippe Conus, Franziska Gamma, and Martin Preisig
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Adult ,Male ,medicine.medical_specialty ,Population ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Aged ,Cardiovascular Diseases/epidemiology ,Cardiovascular Diseases/etiology ,Case-Control Studies ,Female ,Humans ,Mental Disorders/complications ,Mental Disorders/drug therapy ,Metabolic Syndrome/epidemiology ,Metabolic Syndrome/etiology ,Middle Aged ,Prospective Studies ,Psychotropic Drugs/adverse effects ,Psychotropic Drugs/therapeutic use ,Switzerland/epidemiology ,medicine ,Bipolar disorder ,Prospective cohort study ,education ,Psychiatry ,Metabolic Syndrome ,education.field_of_study ,Psychotropic Drugs ,business.industry ,Mortality rate ,Mental Disorders ,Case-control study ,medicine.disease ,030227 psychiatry ,Psychiatry and Mental health ,Cardiovascular Diseases ,Cohort ,medicine.symptom ,Metabolic syndrome ,business ,Weight gain ,030217 neurology & neurosurgery ,Switzerland - Abstract
Psychiatric patients are known to be at high risk of developing cardiovascular diseases (CVDs), leading to an increased mortality rate. To assess the CVD risk (presence of metabolic syndrome [MetS] and calculated 10-year CVD risk) in a Swiss psychiatric cohort taking weight gain-inducing psychotropic drugs, compare the findings to a Swiss population-based cohort, and evaluate the prevalence of participants treated for metabolic disruptions in both cohorts. Data for 1,216 psychiatric patients (of whom 634 were aged 35-75 years) were obtained between 2007 and 2017 from a study with metabolic parameters monitored during psychotropic treatment and between 2003 and 2006 for 6,733 participants from the population-based CoLaus|PsyCoLaus study. MetS as defined by the International Diabetes Federation (IDF) was identified in 33% of the psychiatric participants and 24.7% of the population-based subjects. Specifically, prevalence per the IDF definition was more than 3 times higher in the psychiatric cohort among women aged 35 to 49 years (25.6% vs 8.0%; P < 10-4). The psychiatric and population-based cohorts, respectively, had comparable predicted CVD risk (10-year risk of CVD event > 20%: 0% vs 0.1% in women and 0.3% vs 1.8% [P = .01] in men; 10-year risk of CVD death > 5%: 8.5% vs 8.4% [P = .58] in women and 13.4% vs 16.6% [P = .42] in men). No difference was observed among the proportion of participants with MetS treated for metabolic disturbances in the two cohorts, with the exception of women aged 35-49 years, for whom those in the psychiatric cohort were half as likely to receive treatment compared to participants in CoLaus|PsyCoLaus (17.8% vs 38.8% per the IDF definition; P = .0004). These findings emphasize the concern that psychiatric patients present an altered metabolic profile and that they do not receive adequate treatment for metabolic disruptions. Presence of metabolic disturbances should be routinely assessed, and adequate follow-up is needed to intervene early after illness onset.
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- 2019
9. Rates and Predictors of Conversion to Schizophrenia or Bipolar Disorder Following Substance-Induced Psychosis
- Abstract
OBJECTIVE: The authors investigated the rates of conversion to schizophrenia and bipolar disorder after a substance-induced psychosis, as well as risk factors for conversion.METHOD: All patient information was extracted from the Danish Civil Registration System and the Psychiatric Central Research Register. The study population included all persons who received a diagnosis of substance-induced psychosis between 1994 and 2014 (N=6,788); patients were followed until first occurrence of schizophrenia or bipolar disorder or until death, emigration, or August 2014. The Kaplan-Meier method was used to obtain cumulative probabilities for the conversion from a substance-induced psychosis to schizophrenia or bipolar disorder. Cox proportional hazards regression models were used to calculate hazard ratios for all covariates.RESULTS: Overall, 32.2% (95% CI=29.7-34.9) of patients with a substance-induced psychosis converted to either bipolar or schizophrenia-spectrum disorders. The highest conversion rate was found for cannabis-induced psychosis, with 47.4% (95% CI=42.7-52.3) converting to either schizophrenia or bipolar disorder. Young age was associated with a higher risk of converting to schizophrenia. Self-harm after a substance-induced psychosis was significantly linked to a higher risk of converting to both schizophrenia and bipolar disorder. Half the cases of conversion to schizophrenia occurred within 3.1 years after a substance-induced psychosis, and half the cases of conversion to bipolar disorder occurred within 4.4 years.CONCLUSIONS: Substance-induced psychosis is strongly associated with the development of severe mental illness, and a long follow-up period is needed to identify the majority of cases.
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- 2018
10. Risk of impaired cognition after prenatal exposure to psychotropic drugs
- Abstract
OBJECTIVE: Prenatal exposure to psychotropic drugs may affect the trajectories of brain development. In a register study, we investigated whether such exposure is associated with long-term impaired cognitive abilities.METHOD: Individuals born in Denmark in 1995-2008 were included. As proxies for cognitive impairment, requiring special needs education, attending special needs school, diagnoses of neurological/mental disorder, missed final examinations, and low school grade average were used. We accounted for maternal confounders.RESULTS: We identified 868 159 individuals of whom 13 983 (1.6%) were prenatally exposed. The adjusted odds ratio (OR) was 0.97[0.92-1.02] for requiring special needs education, 1.28[1.14-1.43] for attending special needs school, 1.32[1.20-1.46] for a neurological/mental disorder diagnosis, 1.37[1.22-1.54] for missing the final examinations, and 1.13[0.82-1.55] for obtaining a low school grade average. Exposure to psycholeptics (primarily antipsychotics and sedatives) was correlated with significantly increased risk for four outcomes. The highest was the risk of missing the primary school examinations (OR: 1.51[1.29-1.76]). The overall highest risk concerned the presence of a neurological/mental disorder after prenatal exposure to psychoanaleptics (primarily antidepressants) (OR: 1.86[1.24-2.78).CONCLUSION: Prenatal exposure to psychotropic drugs affects proxy outcomes of cognitive disabilities at school age. Exposure to psycholeptics carries the largest risk. The role of psychoanaleptics is currently unclear.
- Published
- 2017
11. Association of variants in SH2B1 and RABEP1 with worsening of low-density lipoprotein and glucose parameters in patients treated with psychotropic drugs
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Mehdi Gholam-Rezaee, Lee Ann Applegate, Philippe Conus, Franziska Gamma, Anaïs Glatard, Lina Quteineh, Wassim Raffoul, Adna Zdralovic, Aurélie Delacrétaz, Nuria Saigi-Morgui, Paris Jafari, Armin von Gunten, Chin B. Eap, and Frederik Vandenberghe
- Subjects
0301 basic medicine ,Blood Glucose ,medicine.medical_specialty ,Genotype ,Population ,Vesicular Transport Proteins ,Type 2 diabetes ,Biology ,Weight Gain ,Polymorphism, Single Nucleotide ,Adaptor Proteins, Signal Transducing/genetics ,Blood Glucose/drug effects ,Body Mass Index ,Cholesterol, LDL/blood ,Cohort Studies ,Humans ,Mental Disorders/complications ,Mental Disorders/drug therapy ,Phenotype ,Prospective Studies ,Psychotropic Drugs/adverse effects ,Vesicular Transport Proteins/genetics ,Weight Gain/drug effects ,Weight Gain/genetics ,Dyslipidemia ,Metabolic syndrome in psychiatry ,Pharmacogenetics of psychotropic drugs ,RABEP1 ,SH2B1 ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Internal medicine ,Genetics ,medicine ,education ,Adaptor Proteins, Signal Transducing ,education.field_of_study ,Psychotropic Drugs ,Mental Disorders ,General Medicine ,Cholesterol, LDL ,medicine.disease ,Obesity ,030104 developmental biology ,Psychotropic drug ,Endocrinology ,Blood sugar regulation ,Body mass index ,030217 neurology & neurosurgery - Abstract
Genetic factors associated with Body Mass Index (BMI) have been widely studied over the last decade. We examined whether genetic variants previously associated with BMI in the general population are associated with cardiometabolic parameter worsening in the psychiatric population receiving psychotropic drugs, a high-risk group for metabolic disturbances. Classification And Regression Trees (CARTs) were used as a tool capable of describing hierarchical associations, to pinpoint genetic variants best predicting worsening of cardiometabolic parameters (i.e total, HDL and LDL-cholesterol, triglycerides, body mass index, waist circumference, fasting glucose, and blood pressure) following prescription of psychotropic drugs inducing weight gain in a discovery sample of 357 Caucasian patients. Significant findings were tested for replication in a second Caucasian psychiatric sample (n=140). SH2B1 rs3888190C>A was significantly associated with LDL levels in the discovery and in the replication sample, with A-allele carriers having 0.2mmol/l (p=0.005) and 0.36mmol/l (p=0.007) higher LDL levels compared to others, respectively. G-allele carriers of RABEP1 rs1000940A>G had lower fasting glucose levels compared to others in both samples (-0.16mmol/l; p
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- 2017
12. Early changes of blood lipid levels during psychotropic drug treatment as predictors of long-term lipid changes and of new onset dyslipidemia
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Stéphane Kolly, Roland Hasler, Karsten Ebbing, Jacques Thonney, Jean-Michel Aubry, Philippe Conus, Nuria Saigi Morgui, Mehdi Gholam-Rezaee, Aurélie Delacrétaz, Anaïs Glatard, Frederik Vandenberghe, Sylvie Berney, Sylfa Fassassi Gallo, Chin B. Eap, Armin von Gunten, Philipp S. Baumann, Alessandra Solida-Tozzi, and Sandrine Valloton Zulauff
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Adult ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Blood lipids ,Kaplan-Meier Estimate ,03 medical and health sciences ,chemistry.chemical_compound ,ddc:616.89 ,Young Adult ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,Area Under Curve ,Cholesterol, HDL/blood ,Cholesterol, LDL/blood ,Dyslipidemias/diagnosis ,Dyslipidemias/epidemiology ,Dyslipidemias/mortality ,Female ,Humans ,Incidence ,Logistic Models ,Mental Disorders/drug therapy ,Middle Aged ,Psychotropic Drugs/adverse effects ,Psychotropic Drugs/therapeutic use ,ROC Curve ,Triglycerides/blood ,Early lipid changes ,Metabolic follow-up ,New onset dyslipidemia ,Predictors ,Psychotropic drugs ,Internal Medicine ,medicine ,Prospective cohort study ,Triglycerides ,Dyslipidemias ,Psychotropic Drugs ,Nutrition and Dietetics ,business.industry ,Cholesterol ,Mental Disorders ,Hypertriglyceridemia ,Cholesterol, HDL ,nutritional and metabolic diseases ,food and beverages ,Cholesterol, LDL ,medicine.disease ,030227 psychiatry ,Hypocholesterolemia ,Endocrinology ,Psychotropic drug ,chemistry ,Cohort ,lipids (amino acids, peptides, and proteins) ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,Dyslipidemia - Abstract
Background Cardiovascular diseases and dyslipidemia represent a major health issue in psychiatry. Many psychotropic drugs can induce a rapid and substantial increase of blood lipid levels. Objective This study aimed to determine the potential predictive power of an early change of blood lipid levels during psychotropic treatment on long-term change and on dyslipidemia development. Methods Data were obtained from a prospective study including 181 psychiatric patients with metabolic parameters monitored during the first year of treatment and with adherence ascertained. Blood lipid levels (ie, total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], non–high-density lipoprotein cholesterol [non-HDL-C], and fasting triglycerides [TGs]) were measured at baseline and after 1, 3, and/or 12 months of treatment. Results Receiver-operating characteristic analyses indicated that early (ie, after 1 month of psychotropic treatment) increases (≥5%) for TC, LDL-C, TG, and non-HDL-C and decrease (≥5%) for HDL-C were the best predictors for clinically relevant modifications of blood lipid levels after 3 months of treatment (≥30% TC, ≥40% LDL-C, ≥45% TG, ≥55% non-HDL-C increase, and ≥20% HDL-C decrease; sensitivity 70%–100%, specificity 53%–72%). Predictive powers of these models were confirmed by fitting longitudinal multivariate models in the same cohort ( P ≤ .03) as well as in a replication cohort (n = 79; P ≤ .003). Survival models showed significantly higher incidences of new onset dyslipidemia (TC, LDL-C, and non-HDL-C hypercholesterolemia, HDL-C hypocholesterolemia, and hypertriglyceridemia) for patients with early changes of blood lipid levels compared to others ( P ≤ .01). Conclusion Early modifications of blood lipid levels following prescription of psychotropic drugs inducing dyslipidemia should therefore raise questions on clinical strategies to control long-term dyslipidemia.
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- 2017
13. Prediction of early weight gain during psychotropic treatment using a combinatorial model with clinical and genetic markers
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Mehdi Gholam-Rezaee, Nicolas Ansermot, Frederik Vandenberghe, Séverine Crettol, Lina Quteineh, Nuria Saigi-Morgui, Philippe Conus, Chin B. Eap, Armin von Gunten, and Aurélie Delacrétaz
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0301 basic medicine ,Adult ,Genetic Markers ,Male ,Longitudinal study ,medicine.medical_specialty ,Pharmacology ,Weight Gain ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Genetics ,Medicine ,Humans ,Longitudinal Studies ,General Pharmacology, Toxicology and Pharmaceutics ,Area Under Curve ,Body Weight/drug effects ,Female ,Middle Aged ,Models, Statistical ,Psychotropic Drugs/adverse effects ,Molecular Biology ,Genetics (clinical) ,Genetic testing ,Psychotropic Drugs ,medicine.diagnostic_test ,business.industry ,Body Weight ,Area under the curve ,medicine.disease ,3. Good health ,030104 developmental biology ,Psychotropic drug ,Genetic marker ,Schizophrenia ,Cohort ,Molecular Medicine ,medicine.symptom ,business ,Weight gain ,030217 neurology & neurosurgery - Abstract
BACKGROUND: Psychotropic drugs can induce significant (>5%) weight gain (WG) already after 1 month of treatment, which is a good predictor for major WG at 3 and 12 months. The large interindividual variability of drug-induced WG can be explained in part by genetic and clinical factors. AIM: The aim of this study was to determine whether extensive analysis of genes, in addition to clinical factors, can improve prediction of patients at risk for more than 5% WG at 1 month of treatment. METHODS: Data were obtained from a 1-year naturalistic longitudinal study, with weight monitoring during weight-inducing psychotropic treatment. A total of 248 Caucasian psychiatric patients, with at least baseline and 1-month weight measures, and with compliance ascertained were included. Results were tested for replication in a second cohort including 32 patients. RESULTS: Age and baseline BMI were associated significantly with strong WG. The area under the curve (AUC) of the final model including genetic (18 genes) and clinical variables was significantly greater than that of the model including clinical variables only (AUCfinal: 0.92, AUCclinical: 0.75, P
- Published
- 2016
14. Dopaminergic drugs and the risk of hip or femur fracture
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Antoine C. G. Egberts, T. P. van Staa, M. E. L. Arbouw, Patrick C. Souverein, F. de Vries, and Kris L. L. Movig
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musculoskeletal diseases ,Adult ,Male ,medicine.medical_specialty ,Adolescent ,Hip Fractures/chemically induced ,Endocrinology, Diabetes and Metabolism ,Dopamine Agents ,Femoral Fractures/chemically induced ,Netherlands/epidemiology ,Psychotropic Drugs/adverse effects ,Young Adult ,Risk Factors ,Internal medicine ,medicine ,Humans ,Femur ,Young adult ,Netherlands ,Aged ,Femur fracture ,Psychotropic Drugs ,business.industry ,Hip Fractures ,Dopaminergic ,Case-control study ,Middle Aged ,Femur fractures ,Rheumatology ,Antidepressive Agents ,Surgery ,Dopamine Agents/administration & dosage ,Antidepressive Agents/adverse effects ,Concomitant ,Case-Control Studies ,Orthopedic surgery ,Parkinson’s disease ,Original Article ,Female ,business ,Femoral Fractures ,Dopaminergic drugs ,Follow-Up Studies - Abstract
SUMMARY: The effect of dopaminergic medication on the risk of hip/femur fractures is not clear. Our results showed a nearly twofold increased risk of hip/femur fractures in current dopaminergic drug users. Concomitant use of antidepressants further increased this risk. Fracture risk assessment may be warranted in elderly users of dopaminergic drugs.INTRODUCTION: Dopaminergic drugs, often used in the treatment of Parkinson's disease, have several pharmacological effects that may increase or decrease the risk of falling and fractures. Thus, the effect of dopaminergic medication on the risk of hip/femur fractures is not clear. The objective of the study was to examine the effect of dopaminergic medication and concomitant use of psychotropics on the risk of hip/femur fractures taking into account the timing of dopaminergic drug use.METHODS: A population-based case-control study in the PHARMO database was conducted for the period 1991 to 2002. Cases were patients aged 18 years and older with a first hip or femur fracture and matched to four control patients by year of birth, sex and geographical region.RESULTS: The study population included 6,763 cases and 26,341 controls. Current use of dopaminergic drugs (1-30 days before the index date) was associated with an increased risk of hip/femur fractures compared to never use (OR(adj) 1.76, 95% CI = 1.39-2.22), but this excess risk rapidly dropped to baseline levels when treatment had been discontinued >1 year ago. Concomitant use of antidepressants among current dopaminergic drug users further increased the risk of hip/femur fractures (OR(adj) 3.51, 95% CI = 2.10-5.87) while there was no additional risk with concomitant use of other psychotropics.CONCLUSIONS: Although the observed association between dopaminergic drugs and fracture risk may not be entirely causal, due to absence of information on the (severity of the) underlying disease, fracture risk assessment may be warranted in elderly users of dopaminergic drugs.
- Published
- 2011
15. Association of PCK1 with Body Mass Index and Other Metabolic Features in Patients With Psychotropic Treatments
- Author
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Gérard Waeber, Enrique Castelao, Martin Preisig, Frederik Vandenberghe, Eva Choong, Mehdi Gholam-Rezaee, Pierre J. Magistretti, Aurélie Delacrétaz, Peter Vollenweider, Lina Quteineh, Philippe Conus, Armin von Gunten, Chin B. Eap, Zoltán Kutalik, Jean-Michel Aubry, and Nuria Saigi-Morgui
- Subjects
Male ,Pharmacology ,Weight Gain ,Body Mass Index ,ddc:616.89 ,0302 clinical medicine ,PCK1 ,Pharmacology (medical) ,Longitudinal Studies ,pharmacogenetics ,2. Zero hunger ,Waist-to-height ratio ,ddc:615 ,0303 health sciences ,education.field_of_study ,Mental Disorders ,Age Factors ,Intracellular Signaling Peptides and Proteins ,Adult ,Female ,Genotype ,Humans ,Intracellular Signaling Peptides and Proteins/genetics ,Mental Disorders/drug therapy ,Middle Aged ,Phosphoenolpyruvate Carboxykinase (GTP)/genetics ,Polymorphism, Single Nucleotide ,Psychotropic Drugs/adverse effects ,Psychotropic Drugs/therapeutic use ,Sex Factors ,Triglycerides/blood ,Waist Circumference/genetics ,Waist-Height Ratio ,Weight Gain/drug effects ,Weight Gain/genetics ,3. Good health ,Psychiatry and Mental health ,Phosphoenolpyruvate Carboxykinase (GTP) ,medicine.symptom ,Waist Circumference ,medicine.medical_specialty ,Population ,030209 endocrinology & metabolism ,metabolic syndrome ,03 medical and health sciences ,Internal medicine ,medicine ,Glyceroneogenesis ,education ,Triglycerides ,030304 developmental biology ,Psychotropic Drugs ,business.industry ,medicine.disease ,Obesity ,Endocrinology ,Metabolic syndrome ,business ,Body mass index ,Weight gain - Abstract
Weight gain is a major health problem among psychiatric populations. It implicates several receptors and hormones involved in energy balance and metabolism. Phosphoenolpyruvate carboxykinase 1 is a rate-controlling enzyme involved in gluconeogenesis, glyceroneogenesis and cataplerosis and has been related to obesity and diabetes phenotypes in animals and humans. The aim of this study was to investigate the association of phosphoenolpyruvate carboxykinase 1 polymorphisms with metabolic traits in psychiatric patients treated with psychotropic drugs inducing weight gain and in general population samples. One polymorphism (rs11552145G > A) significantly associated with body mass index in the psychiatric discovery sample (n = 478) was replicated in 2 other psychiatric samples (n(1) = 168, n(2) = 188), with AA-genotype carriers having lower body mass index as compared to G-allele carriers. Stronger associations were found among women younger than 45 years carrying AA-genotype as compared to G-allele carriers (-2.25 kg/m(2), n = 151, P = 0.009) and in the discovery sample (-2.20 kg/m(2), n = 423, P = 0.0004). In the discovery sample for which metabolic parameters were available, AA-genotype showed lower waist circumference (-6.86 cm, P = 0.008) and triglycerides levels (-5.58 mg/100 mL, P < 0.002) when compared to G-allele carriers. Finally, waist-to-hip ratio was associated with rs6070157 (proxy of rs11552145, r(2) = 0.99) in a population-based sample (N = 123,865, P = 0.022). Our results suggest an association of rs11552145G > A polymorphism with metabolic-related traits, especially in psychiatric populations and in women younger than 45 years.
- Published
- 2015
16. Novel Psychoactive Substances and Behavioral Addictions
- Author
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Ornella Corazza, Sophia Achab, Zsolt Demetrovics, and Giovanni Martinotti
- Subjects
Psychotropic Drugs ,Article Subject ,General Immunology and Microbiology ,Substance-Related Disorders ,business.industry ,lcsh:R ,Internet privacy ,lcsh:Medicine ,General Medicine ,Creative commons ,Psychotropic Drugs/adverse effects ,Behavioral addictions ,General Biochemistry, Genetics and Molecular Biology ,ddc:616.89 ,Editorial ,Humans ,Medicine ,Substance-Related Disorders/metabolism/physiopathology/psychology/therapy ,business ,Attribution ,License - Abstract
Copyright © 2014 Giovanni Martinotti et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Date of Acceptance: 09/11/2014
- Published
- 2014
17. Psychotropic drug-induced weight gain and other metabolic complications in a Swiss psychiatric population
- Author
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Javier Bartolomei, Chin B. Eap, Eva Choong, Guido Bondolfi, Manuela Ioana Etter, Jean-Michel Aubry, Françoise Jermann, and Mehdi Gholam-Rezaee
- Subjects
Olanzapine ,Male ,Time Factors ,Appetite ,Psychotropic Drugs/adverse effects ,Body Mass Index ,Cohort Studies ,ddc:616.89 ,0302 clinical medicine ,Switzerland/epidemiology ,Prevalence ,Clozapine ,education.field_of_study ,Obesity/chemically induced/epidemiology ,Mental Disorders ,Middle Aged ,3. Good health ,Psychiatry and Mental health ,Psychotropic drug ,Cohort ,Female ,medicine.symptom ,Switzerland ,medicine.drug ,Cohort study ,Adult ,medicine.medical_specialty ,Adolescent ,Population ,Hypercholesterolemia ,Appetite/drug effects ,Hypercholesterolemia/chemically induced/epidemiology ,Statistics, Nonparametric ,03 medical and health sciences ,Young Adult ,medicine ,Humans ,Body Weight/drug effects ,Obesity ,education ,Psychiatry ,Biological Psychiatry ,Aged ,Psychotropic Drugs ,business.industry ,Body Weight ,030227 psychiatry ,Quetiapine ,Mental Disorders/drug therapy/epidemiology ,business ,Weight gain ,030217 neurology & neurosurgery - Abstract
To describe the weight gain-related side-effects of psychotropic drugs and their consequences on metabolic complications (hypercholesterolemia, obesity) in a Swiss cohort of psychiatric patients.This cross-sectional observational study was performed in an out-patient psychiatric division with patients having received for more than 3 months the following drugs: clozapine, olanzapine, quetiapine, risperidone, lithium, and/or valproate. Clinical measures and lifestyle information (smoking behaviour, physical activity) were recorded.196 inclusions were completed. Weight gain (≥10% of initial weight) following drug treatment was reported in 47% of these patients. Prevalence of obesity (BMI ≥ 30), hypercholesterolemia (≥6.2 mmol/L) and low HDL-cholesterol (1.0 mmol/L in men,1.3 mmol/L in women) were present in 38%, 21%, and 27% of patients, respectively. A higher standardised dose, an increase of appetite following medication introduction, the type of medication (clozapine or olanzapine quetiapine or risperidone lithium or valproate), and the gender were shown to be significantly associated with evolution of BMI.High prevalence of obesity and hypercholesterolemia was found in an out-patient psychiatric population and confirms drug-induced weight gain complications during long-term treatment. The results support the recently published recommendations of monitoring of metabolic side-effects during treatment with atypical antipsychotics. Moreover, the weight gain predictors found in the present study could help to highlight patients with special health care management requirement.
- Published
- 2011
18. Biology of gait control: vitamin D involvement
- Author
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Joe Verghese, Cédric Annweiler, Gilles Allali, Olivier Beauchet, Bruno Fantino, and François Herrmann
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Questionnaires ,Male ,Vitamin D/*analogs & derivatives/blood ,medicine.medical_specialty ,Poison control ,STRIDE ,Psychotropic Drugs/adverse effects ,Mental Disorders/drug therapy/physiopathology ,Residence Characteristics ,Gait/drug effects/*physiology ,Internal medicine ,Surveys and Questionnaires ,medicine ,Vitamin D and neurology ,Humans ,Cognitive decline ,Vitamin D ,Gait ,Gait Disorders, Neurologic ,Aged ,Retrospective Studies ,Aged, 80 and over ,Psychiatric Status Rating Scales ,Psychotropic Drugs ,Proprioception ,business.industry ,Mental Disorders ,Confounding ,Gait Disorders, Neurologic/*blood/etiology/*physiopathology ,ddc:616.8 ,Surgery ,Preferred walking speed ,Cross-Sectional Studies ,ddc:618.97 ,Cardiology ,Regression Analysis ,Female ,Neurology (clinical) ,business ,human activities - Abstract
BACKGROUND: Adverse neuromuscular events have been described in case of low serum 25-hydroxyvitamin D (25OHD) concentrations, suggesting that vitamin D may be involved in gait stability. The objective of this cross-sectional study was to examine the association between stride-to-stride variability of stride time (STV) and serum 25OHD concentration in adults aged 65 years and older. METHODS: STV and 25OHD concentration were assessed in 411 community-dwelling older adults (mean age 70.4 +/- 1.8 years, 57.9% women). The following established 25OHD thresholds were used: severe 25OHD insufficiency 30 ng/mL. Age, number of drugs used per day, use of psychoactive drugs, depressive symptoms, cognitive decline, history of falls, distance visual acuity, lower limb proprioception, center of mass (CoM) motion, and walking speed were considered as potential confounders. RESULTS: A total of 16.6% (n = 68) of subjects had severe 25OHD insufficiency, 70.3% (n = 289) moderate insufficiency, and 13.1% (n = 54) normal concentrations. In the full adjusted and the stepwise backward linear regression models, high STV (worse performance) was associated with severe 25OHD insufficiency (p = 0.028 and p = 0.044, respectively), high CoM motion (p = 0.031 and p = 0.014, respectively), and low lower limb proprioception score (p = 0.017 and p = 0.008, respectively). The stepwise backward regression model also showed that high STV was associated with female gender (p = 0.041). CONCLUSIONS: Low serum 25OHD concentrations were associated with high STV reflecting a disturbed gait control. This association could be explained by a possible action of vitamin D on different components involved in gait control.
- Published
- 2011
19. Evaluation de l'impact de l'Opération Nez Rouge pendant la Fête des Vignerons 1999
- Author
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Geense, Rachel and Kellerhals, Christophe
- Subjects
Accident Prevention ,Accidents, Traffic/psychology ,Accidents, Traffic/prevention & control ,Automobile Driving ,Alcohol Drinking/psychology ,Alcohol Drinking/prevention & control ,Psychotropic Drugs/adverse effects ,Fatigue/physiopathology ,Health Promotion/supply & distribution ,Health Promotion/organization & administration ,Preventive Health Services/supply & distribution ,Preventive Health Services/organization & administration ,Switzerland ,Vaud - Abstract
La Fondation Nez rouge a mandaté l'Institut universitaire de médecine sociale et préventive de Lausanne (IUMSP) pour une évaluation de leur action pendant la Fête des Vignerons 1999. Le but de cette étude était de déterminer l'impact de l'opération Nez rouge sur la diffusion du concept de "chauffeur délégué" (i.e. une personne du groupe s'engage à ne pas boire pendant une sortie et à ramener les autres). [Table des matières] 1. Questions d'évaluation. 2. Méthodes. 3. Résultats. 3.1. L'enquête "tous-conducteurs" : caractéristiques des répondants (sexe, âge, état d'ébriété), présentation des thèmes (la visibilité de Nez Rouge et la diffusion du concept du chauffeur délégué), la prévention à la Fête des Vignerons (souvenir spontané), perception de la campagne Nez Rouge. 3.2. Comparaison entre les caractéristiques des répondants et des refusants. 3.3. Les rapatriements effectués par Nez Rouge. 3.4. Les actions (itinérantes) de prévention. 4. Recommandations. 5. Questionnaire d'enquête "tous-conducteurs", comparaison du nombre de transports par jour/personnes rapatriées.
- Published
- 2000
20. Psychotropic drug-induced genetic-epigenetic modulation of CRTC1 gene is associated with early weight gain in a prospective study of psychiatric patients
- Author
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Delacrétaz A, Glatard A, Dubath C, Gholam-Rezaee M, Jv, Sanchez-Mut, Gräff J, Armin von Gunten, Conus P, and Cb, Eap
- Subjects
Adult ,Male ,Age of Onset ,Alleles ,Case-Control Studies ,CpG Islands/drug effects ,DNA Methylation/drug effects ,Epigenesis, Genetic ,Female ,Genetic Association Studies ,Humans ,Longitudinal Studies ,Middle Aged ,Obesity/chemically induced ,Obesity/genetics ,Polymorphism, Single Nucleotide ,Prospective Studies ,Psychotropic Drugs/adverse effects ,Psychotropic Drugs/pharmacology ,Transcription Factors/genetics ,Weight Gain/genetics ,CRTC1 ,Early weight gain ,Methylation ,Psychiatric population ,Psychotropic drugs ,body-mass index ,epigenome-wide ,Weight Gain ,metabolic syndrome ,insulin-resistance ,Obesity ,bipolar disorder ,Psychotropic Drugs ,Research ,DNA Methylation ,schizophrenia ,mood stabilizers ,antipsychotics ,depression ,CpG Islands ,Transcription Factors - Abstract
Background: Metabolic side effects induced by psychotropic drugs represent a major health issue in psychiatry. CREB-regulated transcription coactivator 1 (CRTC1) gene plays a major role in the regulation of energy homeostasis and epigenetic mechanisms may explain its association with obesity features previously described in psychiatric patients. This prospective study included 78 patients receiving psychotropic drugs that induce metabolic disturbances, with weight and other metabolic parameters monitored regularly. Methylation levels in 76 CRTC1 probes were assessed before and after 1 month of psychotropic treatment in blood samples. Results: Significant methylation changes were observed in three CRTC1 CpG sites (i.e., cg07015183, cg12034943, and cg 17006757) in patients with early and important weight gain (i.e., equal or higher than 5% after 1 month; FDR p value = 0.02). Multivariable models showed that methylation decrease in cg12034943 was more important in patients with early weight gain (>= 5%) than in those who did not gain weight (p = 0.01). Further analyses combining genetic and methylation data showed that cg12034943 was significantly associated with early weight gain in patients carrying the G allele of rs4808844A>G (p = 0.03), a SNP associated with this methylation site (p = 0.03). Conclusions: These findings give new insights on psychotropic-induced weight gain and underline the need of future larger prospective epigenetic studies to better understand the complex pathways involved in psychotropic-induced metabolic side effects.
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