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Food craving and consumption evolution in patients starting treatment with clozapine

  • Marina GarrigaEmail author
  • Andrea Mallorquí
  • Lourdes Serrano
  • José Ríos
  • Manel Salamero
  • Eduard Parellada
  • Marta Gómez-Ramiro
  • Cristina Oliveira
  • Silvia Amoretti
  • Eduard Vieta
  • Miquel Bernardo
  • Clemente García-Rizo
Original Investigation
  • 41 Downloads

Abstract

Background

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).

Methods

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.

Results

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).

Conclusions

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.

Keywords

Antipsychotic-induced weight gain Clozapine Food Craving Inventory (FCI) Serious mental illness 

Notes

Acknowledgments

The authors express gratitude to patients that voluntarily participated in this project.

Authors’ contribution

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

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.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Marina Garriga
    • 1
    • 2
    • 3
    • 4
    Email author
  • Andrea Mallorquí
    • 5
  • Lourdes Serrano
    • 5
  • José Ríos
    • 6
    • 7
  • Manel Salamero
    • 5
  • Eduard Parellada
    • 2
    • 3
    • 4
    • 8
  • Marta Gómez-Ramiro
    • 8
  • Cristina Oliveira
    • 8
  • Silvia Amoretti
    • 2
    • 3
    • 4
    • 8
  • Eduard Vieta
    • 1
    • 2
    • 3
    • 4
  • Miquel Bernardo
    • 2
    • 3
    • 4
    • 8
  • Clemente García-Rizo
    • 2
    • 3
    • 4
    • 8
  1. 1.Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic BarcelonaUniversity of BarcelonaBarcelonaSpain
  2. 2.Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS)BarcelonaSpain
  3. 3.Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM)MadridSpain
  4. 4.Department of MedicineUniversity of BarcelonaBarcelonaSpain
  5. 5.Department of Psychiatry, Institute of Neuroscience, Hospital Clinic BarcelonaUniversity of BarcelonaBarcelonaSpain
  6. 6.Medical Statistics Core FacilityHospital Clinic BarcelonaBarcelonaSpain
  7. 7.Biostatistics Unit, Faculty of MedicineUniversitat Autònoma de BarcelonaBarcelonaSpain
  8. 8.Barcelona Clinic Schizophrenia Unit (BCSU), Institute of Neuroscience, Hospital Clinic of BarcelonaUniversity of BarcelonaBarcelonaSpain

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