Obesity-related metabolic disturbances and quality of life in subjects diagnosed with schizophrenia treated with atypical neuroleptics

Introduction: Weight gain and related metabolic disturbances are frequent side effects observed during treatment with atypical neuroleptics, most commonly with olanzapine and quetiapine. Weight gain may also deteriorate the quality of life and cause treatment discontinuation. However, the use of these neuroleptics in orodispensible tablet (ODT) form was related to lower frequency of weight gain. Therefore, the aim of this study was to evaluate the incidence of weight gain and metabolic disturbances in patients with schizophrenia treated with classical tablet (SOT) and orodispensible (ODT) formulations of olanzapine and quetiapine, and analyze the relationship between the occurrence of these side effects and quality of life and patient attitude to the treatment depending on the therapy used.

Material and methods: A three-month questionnaire survey was performed by 400 psychiatrists from across Poland, during three consecutive outpatient visits. 4437 adult patients with schizophrenia treated with atypical neuroleptics for at least one month but not more than 12 months were enrolled.

Results: Weight gain was significantly more common among patients treated with olanzapine than those treated with quetiapine (54.7% vs. 20%, p < 0.001 and 34.7% vs. 28.6%, p < 0.01, on visits 1 and 3, respectively), and was less frequently observed in patients treated with ODT formulations. The prevalence of hypertension and type 2 diabetes on the treatment did not change significantly. Treatment with olanzapine regardless of the form used was associated with a better quality of life and a more positive attitude of the patient towards the treatment.

Conclusions: The risk of weight gain is greater during treatment with olanzapine than quetiapine. However, olanzapine use is associated with better quality of life and a more positive attitude of the patient towards the treatment. The use of neuroleptics in the ODT form may reduce the risk of weight gain but does not significantly affect the quality of life or the attitude of the patient towards the treatment.