Risperidone-related weight gain: genetic and nongenetic predictors

Area of Science:

• Pharmacogenetics
• Schizophrenia Treatment
• Metabolic Side Effects

Background:

• Atypical antipsychotics, such as risperidone, are associated with significant weight gain, a major concern for patient adherence and health.
• Both genetic predispositions and environmental factors are suspected to play a role in antipsychotic-induced weight gain.
• Understanding these factors is crucial for personalized treatment strategies in schizophrenia.

Purpose of the Study:

• To investigate the combined influence of multiple candidate genes and environmental factors on body weight changes in schizophrenia patients treated with risperidone.
• To identify specific genetic variants and clinical variables associated with risperidone-induced weight gain.

Main Methods:

• A cohort of 123 Han Chinese schizophrenia inpatients received risperidone monotherapy for up to 42 days.
• Body weight, clinical symptoms (PANSS), and side effects (ESRS, UKU) were assessed biweekly.
• Statistical analysis using generalized estimating equation (GEE) regression examined the impact of 15 genetic polymorphisms and clinical factors on body weight.

Main Results:

• Five genetic polymorphisms (5-HT2A, 5-HT2C, 5-HT6, BDNF, CYP2D6) were found to significantly influence body weight.
• Baseline body weight, age, gender, schizophrenia subtype, treatment duration, and treatment efficacy also significantly affected weight gain.
• The study identified a complex interplay between genetic and non-genetic factors in risperidone-associated weight changes.

Conclusions:

• Numerous genetic and non-genetic factors contribute to antipsychotic-related weight gain.
• These findings underscore the importance of considering individual genetic profiles and clinical characteristics for managing weight side effects.
• Further research into personalized medicine approaches for schizophrenia treatment is warranted.