Koen P Grootens1,2, Anna Meijer3,4, Erwin G Hartong5, Bennard Doornbos6, P Roberto Bakker7,8, Asmar Al Hadithy9, Kirsten N Hoogerheide10, Frans Overmeire11, Radboud M Marijnissen4,12, Henricus G Ruhe13,4. 1. Reinier van Arkel, Bethaniestraat 2, 5211 LJ, 's-Hertogenbosch, The Netherlands. k.grootens@reiniervanarkel.nl. 2. Radboud University Medical Centre, Nijmegen, The Netherlands. k.grootens@reiniervanarkel.nl. 3. Department of Teacher Education, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands. 4. University Medical Centre Groningen, Groningen, The Netherlands. 5. Department of Psychiatry, Canisius Wilhelmina Hospital Nijmegen, Nijmegen, The Netherlands. 6. GGZ Drenthe, Assen, The Netherlands. 7. GGZ Centraal, Amersfoort, The Netherlands. 8. Maastricht University, Maastricht, The Netherlands. 9. Parnassia Group, The Hague, The Netherlands. 10. De Jutters, The Hague, The Netherlands. 11. VMDB (Dutch association of patients with bipolar disorder and their relatives), Amersfoort, Netherlands. 12. Pro Persona, Wolfheze, The Netherlands. 13. Radboud University Medical Centre, Nijmegen, The Netherlands.
Abstract
OBJECTIVE: To present up-to-date information and recommendations on the management of body weight changes during the use of antiepileptic mood stabilizers in bipolar disorder to help clinicians and patients make well-informed, practical decisions. DATA SOURCES: Umbrella review. Systematic reviews and meta-analyses on the prevention, treatment, and monitoring of body weight changes as a side effect of the mood stabilizers valproate, lamotrigine, topiramate, and carbamazepine were identified in Embase (2010-2015, no language restrictions). STUDY SELECTION: The search yielded 18 relevant publications on antiepileptic mood stabilizers and weight changes in bipolar disorder. DATA EXTRACTION: Relevant scientific evidence was abstracted and put into a clinical perspective by a multidisciplinary expert panel of clinicians with expertise in the treatment of bipolar disorders across all age groups and a patient representative. RESULTS: Valproate has been proven to be associated with weight gain in up to 50% of its users, and can be detected 2-3 months after initiation. Carbamazepine has been proven to have a low risk of weight gain. Lamotrigine and topiramate are associated with weight loss. Other option for this sentence = Weigth gain has been proven to be associated with valproate use in up to 50% of its users, and can be detected within 2-3 months after initiation. CONCLUSION: Each antiepileptic mood stabilizer has specific effects on body weight and accordingly requires a discrete education, prevention, monitoring, and treatment strategy. Clinicians are recommended to adopt an active, anticipatory approach, educating patients about weight change as an important side effect in order to come to informed shared decisions about the most suitable mood stabilizer.
OBJECTIVE: To present up-to-date information and recommendations on the management of body weight changes during the use of antiepileptic mood stabilizers in bipolar disorder to help clinicians and patients make well-informed, practical decisions. DATA SOURCES: Umbrella review. Systematic reviews and meta-analyses on the prevention, treatment, and monitoring of body weight changes as a side effect of the mood stabilizers valproate, lamotrigine, topiramate, and carbamazepine were identified in Embase (2010-2015, no language restrictions). STUDY SELECTION: The search yielded 18 relevant publications on antiepileptic mood stabilizers and weight changes in bipolar disorder. DATA EXTRACTION: Relevant scientific evidence was abstracted and put into a clinical perspective by a multidisciplinary expert panel of clinicians with expertise in the treatment of bipolar disorders across all age groups and a patient representative. RESULTS:Valproate has been proven to be associated with weight gain in up to 50% of its users, and can be detected 2-3 months after initiation. Carbamazepine has been proven to have a low risk of weight gain. Lamotrigine and topiramate are associated with weight loss. Other option for this sentence = Weigth gain has been proven to be associated with valproate use in up to 50% of its users, and can be detected within 2-3 months after initiation. CONCLUSION: Each antiepileptic mood stabilizer has specific effects on body weight and accordingly requires a discrete education, prevention, monitoring, and treatment strategy. Clinicians are recommended to adopt an active, anticipatory approach, educating patients about weight change as an important side effect in order to come to informed shared decisions about the most suitable mood stabilizer.
Entities:
Keywords:
Anti-obesity agents; Bipolar disorder; Body weight changes; Carbamazepine; Lamotrigine; Topiramate; Valproate; Weight gain; Weight loss
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