Association Between Second-Generation Antipsychotics and Changes in Body Mass Index in Adolescents

PurposeTo assess the association of second-generation antipsychotics (SGAs) with changes in body mass index (BMI) among adolescents compared with a matched untreated comparison group.MethodsA retrospective cohort study was conducted using an electronic medical record database between January 2004 and July 2009. Adolescents (12–19 years old), newly initiated on SGAs formed the exposure group and untreated adolescents formed the comparison group matched (3:1) to the antipsychotic group based on age, gender, and month of index SGA. Both the exposure and comparison groups were followed for slightly more than a year (395 days). Baseline and follow-up BMI were evaluated for both groups and percentage change from baseline BMI to follow-up BMI was calculated. Multivariate linear regression was conducted to assess the impact of SGAs on percent change in follow-up BMI from baseline controlling for demographic characteristics, baseline medications, comorbidities, and other covariates.ResultsThe mean percentage increase in follow-up BMI from baseline for antipsychotic group was significantly higher than the comparison group (p < .01). After adjusting for covariates, adolescents on olanzapine had the highest percentage increase in follow-up BMI from baseline (5.84%, 95% confidence interval [CI], 4.07–7.61) followed by aripiprazole (4.36%; 95% CI, 3.08–5.64), risperidone (3.65%; 95% CI, 2.61–4.68), and quetiapine (1.53%; 95% CI, .53–2.52) compared with the comparison group.ConclusionThis study further validates a growing concern of increased BMI in adolescents on SGA therapy.