Food craving and consumption evolution in patients starting treatment with clozapine
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Antipsychotic-induced weight gain has been especially related to clozapine and olanzapine. Underlying mechanisms in relation to food preferences with an increased food craving and consumption of specific nutrients have not been extensively studied in patients with serious mental illness (SMI). We aim to describe specific food preferences (craving) and subsequent food consumption in SMI patients starting clozapine, as well as their possible relation to weight and body mass index (BMI).
An observational prospective follow-up study (18 weeks) was conducted in a cohort of 34 SMI patients who started clozapine due to resistant-psychotic symptoms. Anthropometric measures, Food Craving Inventory (FCI), and a food consumption frequency questionnaire were evaluated at baseline, weeks 8 and 18 of treatment. Statistical analysis included generalized estimating equations models with adjustment for potential confounding factors.
No longitudinal changes over time were found across the different food craving scores after 18 weeks of treatment. However, adjusted models according to BMI status showed that the normal weight (NW) group presented an increased score for the “complex carbohydrates/proteins” food cravings (− 0.67; 95% CI [− 1.15, − 0.19]; P = 0.010), while baseline scores for “fast-food fats” cravings were significantly higher in the overweight/obese (OWO) group in comparison with NW patients (NW, 2.05; 95% CI [1.60, 2.49]; OWO, 2.81, 95% CI [2.37, 3.25]; P = 0.016). When considering if food craving could predict weight gain, only increments in “fast-food fats” cravings were associated (β = − 5.35 ± 1.67; 95% CI [− 8.64, − 2.06]; P = 0.001).
No longitudinal differences were found for any of the food craving scores evaluated; however, in the NW group, food craving for “complex carbohydrates/proteins” changed. Thus, changes in “fast-food fats” cravings predicted weight increase in this sample. Interventions targeting food preferences may help to mitigate weight gain in patients starting treatment with clozapine.
KeywordsAntipsychotic-induced weight gain Clozapine Food Craving Inventory (FCI) Serious mental illness
The authors express gratitude to patients that voluntarily participated in this project.
MG: conception and design of the article, acquisition, analyses, and interpretation of data, and drafting the manuscript. AM: conception and design of the article, acquisition, and interpretation of data, revising critically for contents. LS: conception and design of the article, acquisition, and interpretation of data, revising critically for contents. JR: analyses, interpretation of data, and revising critically for contents. MS: analyses, interpretation of data, and revising critically for contents. EP: revising the manuscript critically for intellectual content and approved the final version of the manuscript. MGR: analyses, interpretation of data, and revising critically for contents. CO: revising the manuscript critically for intellectual content and approved the final version of the manuscript. SA: acquisition and interpretation of data, revising critically for contents. EV: revising the manuscript critically for intellectual content and approved the final version of the manuscript. MB: revising the manuscript critically for intellectual content and approved the final version of the manuscript. CGR: conception and design of the article, revising the manuscript critically for intellectual content, and approved the final version of the manuscript.
Funding for this study was provided by the Spanish Ministry of Economy and Competitiveness (PI14/00753) integrated into the State Plan of Scientific and Technical Research and Innovation 2013–2016 and co-financed by the ISCIII-General Evaluation Branch and the European Regional Development Fund (FEDER), Instituto de SaludCarlos III through a ‘Rıo Hortega’ contract (CM17/00102, to Dr. Garriga), FEDER, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Government of Catalonia, Secretaria d’Universitats i Recerca del Departament d’Economia i Coneixement (2017SGR1355 and 2017SGR1365), FI-DGR-2013 Contract of the Agència de Gestió d’Ajuts Universitaris i de Recerca, Esther Koplowitz Center-Barcelona (Dr. Bernardo), and the CERCA Programme/Generalitat de Catalunya.
Compliance with ethical standards
The protocol was approved by the local Ethical Committee and conducted in conformity with the Declaration of Helsinki.
Conflict of interest
Marina Garriga has received grants and served as consultant or advisor for Ferrer, Lundbeck, Janssen, Spanish Ministry of Economy and Competitiveness, Instituto de Salud Carlos III through a ‘Rıo Hortega’ contract (CM17/00102), FEDER, and Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM).
Marta Gómez-Ramiro has received grant/research/travel support from Alter, Janssen, Lundbeck, Otsuka, Pfizer, Sanofi-Aventis.
Eduard Parellada has received honoraria and/or research grants from the Fondo de Investigación Sanitaria of the Spanish Ministry of Science and Innovation, MINECO, Pons Balmes Grant, Fundació la Marató de TV3 of Catalonia, Janssen-Cilag, GlaxoSmithKline, Ferrer and ADAMED.
Eduard Vieta has received grants, CME-related honoraria, or consulting fees from Alexza, Almirall, AstraZeneca, Bristol-Myers Squibb, Cephalon, Eli Lilly, Ferrer, Forest Research Institute, Gedeon Richter, GlaxoSmith-Kline, Janssen, Janssen-Cilag, Jazz, Johnson & Johnson, Lundbeck, Merck, Novartis, Organon, Otsuka, Pfizer, Pierre-Fabre, Qualigen, Roche, Sanofi-Aventis, Schering-Plough, Servier, Shire, Solvay, Takeda, Teva, CIBERSAM, the Seventh European Framework Programme (ENBREC), the Stanley Medical Research Institute, United Biosource Corporation, and Wyeth.
Miquel Bernardo has been a consultant for, received grant/research support and honoraria from, and been on the speakers/advisory board of ABBiotics, Adamed, Angelini, Casen Recordati, Eli Lilly, Janssen-Cilag, Lundbeck, Otsuka, Somatics, Takeda and has obtained research funding from the Ministry of Education, Culture and Sport, the Spanish Ministry of Economy, Industry and Competitiveness (CIBERSAM), by the Government of Catalonia, Secretaria d’Universitats i Recerca del Departament d’Economia i Coneixement (2017SGR1355), Foundation European Group for Research In Schizophrenia (EGRIS), and the 7th Framework Program of the European Union.
Clemente García-Rizo has received honoraria/travel support from Janssen-Cilag, Lundbeck and Ferrer.
The other authors do not declare any conflict of interest.
- American Psychiatric Association (APA) (2000) Diagnostic and statistical manual of mental disorders: DSM-IV-TR. American Psychiatric Association, WashingtonGoogle Scholar
- Fernø J, Varela L, Skrede S, Vázquez MJ, Nogueiras R, Diéguez C, Vidal-Puig A, Steen VM, López M (2011) Olanzapine-induced hyperphagia and weight gain associate with orexigenic hypothalamic neuropeptide signaling without concomitant AMPK phosphorylation. PLoS One 6:e20571. https://doi.org/10.1371/journal.pone.0020571 CrossRefGoogle Scholar
- Guy W (2000) Clinical Global Impression (CGI). In: Rush AJ (ed) Handbook of psychiatric measures. American Psychiatric Association, Washington, DC, pp 100–102Google Scholar
- Jáuregui Lobera I, Bolaños P, Carbonero R, Valero Blanco E (2010) Psychometric properties of the Spanish version of Food Craving Inventory (FCI-SP). Nutr Hosp 25:984–992Google Scholar
- Kluge M, Schuld A, Himmerich H, Dalal M, Schacht A, Wehmeier PM, Hinze-Selch D, Kraus T, Dittmann RW, Pollmächer T (2007) Clozapine and olanzapine are associated with food craving and binge eating. J Clin Psychopharmacol 27:662–666. https://doi.org/10.1097/jcp.0b013e31815a8872 CrossRefGoogle Scholar
- Kroeze WK, Hufeisen SJ, Popadak BA, Renock SM, Steinberg SA, Ernsberger P, Jayathilake K, Meltzer HY, Roth BL (2003) H1-histamine receptor affinity predicts short-term weight gain for typical and atypical antipsychotic drugs. Neuropsychopharmacology 28:519–526. https://doi.org/10.1038/sj.npp.1300027 CrossRefGoogle Scholar
- Milano W, De Rosa M, Milano L, Capasso A (2013) Antipsychotic drugs opposite to metabolic risk: neurotransmitters, neurohormonal and pharmacogenetic mechanisms underlying with weight gain and metabolic syndrome. Open Neurol J 7:23–31. https://doi.org/10.2174/1874205X01307010023 CrossRefGoogle Scholar
- Olfson M, Blanco C, Liu S-M, Wang S, Correll CU (2012) National trends in the office-based treatment of children, adolescents, and adults with antipsychotics. Arch Gen Psychiatry 69:1247–1256. https://doi.org/10.1001/archgenpsychiatry.2012.647 CrossRefGoogle Scholar
- Rodríguez IT, Ballart JF, Pastor GC et al (2008) Validation of a short questionnaire on frequency of dietary intake: reproducibility and validity. Nutr Hosp 23:242–252Google Scholar
- World Health Organization (1995) WHO Expert Committee on Physical Status : the Use and Interpretation of Anthropometry (1993 : Geneva, Switzerland) & World Health Organization. (1995). Physical status : the use of and interpretation of anthropometry, report of a WHO expert committee. World Health OrganizationGoogle Scholar