Alastair J Flint1, Anthony J Rothschild2, Ellen M Whyte3, George S Alexopoulos4, Benoit H Mulsant5, Patricia Marino4, Samprit Banerjee6, Cristina D Pollari4, Yiyuan Wu6, Aristotle N Voineskos5, Barnett S Meyers4. 1. Department of Psychiatry (AJF, BHM, ANV), University of Toronto, ON, Canada; Centre for Mental Health, University Health Network (AJF), Toronto, ON, Canada. Electronic address: alastair.flint@uhn.ca. 2. University of Massachusetts Medical School and UMass Memorial Health Care (AJR), Worcester, MA. 3. Department of Psychiatry (EMW), UPMC Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA. 4. Department of Psychiatry (GSA, PM, CDP, BSM)), Weill Cornell Medicine of Cornell University and New York Presbyterian Hospital, Westchester Division, NY. 5. Department of Psychiatry (AJF, BHM, ANV), University of Toronto, ON, Canada; Centre for Addiction and Mental Health (BHM, ANV), Toronto, ON, Canada. 6. Department of Healthcare Policy and Research (SB, YW), Weill Cornell Medical College, New York, NY.
Abstract
OBJECTIVE: To examine the effect of older versus younger age on change in anthropometric and metabolic measures during extended treatment of psychotic depression with sertraline plus olanzapine. METHODS: Two hundred and sixty-nine men and women aged 18-85 years with an episode of psychotic depression were treated with open-label sertraline plus olanzapine for up to 12 weeks. Participants who remained in remission following an 8-week stabilization phase were eligible to participate in a 36-week randomized controlled trial (RCT) that compared the efficacy and tolerability of sertraline plus olanzapine with sertraline plus placebo. Weight, waist circumference and plasma lipids, glucose, HbA1c, and insulin were measured at regular intervals during the acute, stabilization and randomized phases of the study. Linear mixed models were used to analyze the trajectories of anthropometric and metabolic measures. RESULTS: Participants aged 60 years or older experienced less weight gain and less increase in cholesterol during the combined acute and stabilization phases of the study compared with those aged 18-59 years. At the acute-stabilization termination visit, mean weight in older participants was 6.5 lb. less than premorbid weight, whereas it was 17.9 lb. more than premorbid weight in younger participants. In the RCT, there was a significant interaction of treatment and age group for the trajectory of weight, but the post hoc tests that compared age groups within each treatment arm were not statistically significant. There were no clinically significant differences between younger and older participants in glycemic measures. CONCLUSION: Older patients with psychotic depression experienced less increase in weight and total cholesterol than their younger counterparts during acute and stabilization treatment with sertraline plus olanzapine. In the older group, weight gained during the acute and stabilization phases appeared to be partial restoration of weight lost during the index episode of depression, whereas weight gain in younger participants was not.
OBJECTIVE: To examine the effect of older versus younger age on change in anthropometric and metabolic measures during extended treatment of psychotic depression with sertraline plus olanzapine. METHODS: Two hundred and sixty-nine men and women aged 18-85 years with an episode of psychotic depression were treated with open-label sertraline plus olanzapine for up to 12 weeks. Participants who remained in remission following an 8-week stabilization phase were eligible to participate in a 36-week randomized controlled trial (RCT) that compared the efficacy and tolerability of sertraline plus olanzapine with sertraline plus placebo. Weight, waist circumference and plasma lipids, glucose, HbA1c, and insulin were measured at regular intervals during the acute, stabilization and randomized phases of the study. Linear mixed models were used to analyze the trajectories of anthropometric and metabolic measures. RESULTS: Participants aged 60 years or older experienced less weight gain and less increase in cholesterol during the combined acute and stabilization phases of the study compared with those aged 18-59 years. At the acute-stabilization termination visit, mean weight in older participants was 6.5 lb. less than premorbid weight, whereas it was 17.9 lb. more than premorbid weight in younger participants. In the RCT, there was a significant interaction of treatment and age group for the trajectory of weight, but the post hoc tests that compared age groups within each treatment arm were not statistically significant. There were no clinically significant differences between younger and older participants in glycemic measures. CONCLUSION: Older patients with psychotic depression experienced less increase in weight and total cholesterol than their younger counterparts during acute and stabilization treatment with sertraline plus olanzapine. In the older group, weight gained during the acute and stabilization phases appeared to be partial restoration of weight lost during the index episode of depression, whereas weight gain in younger participants was not.
Authors: K S Bingham; B S Meyers; B H Mulsant; A J Rothschild; E M Whyte; S Banerjee; A S Artis; G S Alexopoulos; A J Flint Journal: Acta Psychiatr Scand Date: 2018-06-29 Impact factor: 6.392
Authors: Alastair J Flint; Barnett S Meyers; Anthony J Rothschild; Ellen M Whyte; George S Alexopoulos; Matthew V Rudorfer; Patricia Marino; Samprit Banerjee; Cristina D Pollari; Yiyuan Wu; Aristotle N Voineskos; Benoit H Mulsant Journal: JAMA Date: 2019-08-20 Impact factor: 56.272
Authors: M D Miller; C F Paradis; P R Houck; S Mazumdar; J A Stack; A H Rifai; B Mulsant; C F Reynolds Journal: Psychiatry Res Date: 1992-03 Impact factor: 3.222
Authors: J Wijkstra; H Burger; W W van den Broek; T K Birkenhäger; J G E Janzing; M P M Boks; J A Bruijn; M L M van der Loos; L M T Breteler; G M G I Ramaekers; R J Verkes; W A Nolen Journal: Acta Psychiatr Scand Date: 2009-08-19 Impact factor: 6.392
Authors: Barnett S Meyers; Alastair J Flint; Anthony J Rothschild; Benoit H Mulsant; Ellen M Whyte; Catherine Peasley-Miklus; Eros Papademetriou; Andrew C Leon; Moonseong Heo Journal: Arch Gen Psychiatry Date: 2009-08
Authors: E Jääskeläinen; T Juola; H Korpela; H Lehtiniemi; M Nietola; J Korkeila; J Miettunen Journal: Psychol Med Date: 2017-09-12 Impact factor: 7.723
Authors: Toby Pillinger; Robert A McCutcheon; Luke Vano; Yuya Mizuno; Atheeshaan Arumuham; Guy Hindley; Katherine Beck; Sridhar Natesan; Orestis Efthimiou; Andrea Cipriani; Oliver D Howes Journal: Lancet Psychiatry Date: 2019-12-17 Impact factor: 77.056
Authors: Alastair J Flint; Barnett S Meyers; Anthony J Rothschild; Ellen M Whyte; Benoit H Mulsant; Matthew V Rudorfer; Patricia Marino Journal: BMC Psychiatry Date: 2013-01-25 Impact factor: 3.630