Bipolar disorder, obesity, and pharmacotherapy-associated weight gain
Bipolar disorder, obesity, and pharmacotherapy-associated weight gain
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DOI：
10.4088/jcp.v64n1205
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发表时间：
2003-12-01
影响因子：
5.3
通讯作者：
McElroy, SL
中科院分区：
文献类型：
--
作者：
Keck, PE;McElroy, SL
背景双相情感障碍、超重和肥胖都是国家公共卫生问题。超重和肥胖似乎也与情绪障碍有关，特别是双相情感障碍患者，可能比一般人群中的个体面临更大的超重和肥胖风险。这种风险可能是由于与疾病本身和/或用于治疗双相情感障碍的药物相关的因素。我们使用关键词锂、奥氮平、丙戊酸盐、丙戊酸、双丙戊酸钠、卡马西平、拉莫三嗪、肥胖、体重和双相情感障碍对所有英文文章（1966-2002）进行了MEDLINE文献检索。我们通过手动审查相关参考文献来增强该检索。我们的重点是研究超重和肥胖的患病率在双相情感障碍，用于治疗双相情感障碍的药物相关的风险和体重增加的幅度，以及预防和治疗超重和肥胖的双相情感障碍患者。双相情感障碍患者似乎比一般人群超重和肥胖的风险更大。共病暴食症;抑郁发作的次数;与体重增加相关的药物治疗，单独或联合;过量的碳水化合物消耗;和低运动率似乎是双相情感障碍患者体重增加和肥胖的危险因素。结论：需要更多的研究来确定双相情感障碍患者超重和肥胖的特定危险因素的影响。这些数据可用于为双相情感障碍患者制定更好的体重增加预防和治疗计划。治疗选择包括饮食咨询，使用情绪稳定剂，降低体重增加的倾向，以及与具有减肥特性的药物联合药物治疗。
Background. Bipolar disorder, overweight, and obesity are each national public health problems. Overweight and obesity also appear to be related to mood disorders, and patients with bipolar disorder, in particular, may be at greater risk for overweight and obesity than individuals in the general population. This risk may be due to factors associated with the illness itself and/or with medications used to treat bipolar disorder.Method. We conducted a MEDLINE literature search of all English-language articles (1966-2002) using the keywords lithium, olanzapine, valproate, valproic acid, divalproex sodium, carbamazepine, lamotrigine, obesity, weight, and bipolar disorder. We augmented this search with manual review of relevant references. Our focus was on studies examining the prevalence of overweight and obesity in bipolar disorder, the risk and magnitude of weight gain associated with medications used to treat bipolar disorder, and the prevention and treatment of overweight and obesity in patients with bipolar disorder.Results: Forty-five studies were reviewed. Patients with bipolar disorder appear to be at greater risk than the general population for overweight and obesity. Comorbid binge-eating disorder; the number of depressive episodes; treatment with medications associated with weight gain, alone or in combination; excessive carbohydrate consumption; and low rates of exercise appear to be risk factors for weight gain and obesity in patients with bipolar disorder.Conclusions: More research is required to identify the impact of specific risk factors for overweight and obesity in patients with bipolar disorder. These data could be used to develop better weight gain prevention and treatment programs for those with bipolar disorder. Therapeutic options include dietary counseling, use of mood stabilizers with lower propensities for weight gain, and combination pharmacotherapy with medications that have weight loss properties.