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Weight change is a frequent side effect of treatment with psychopharmacology. Weight gain occurs with various chemical structures of psychopharmacological agents. Some drugs are associated with weight gain in susceptible individuals of up to 20 kilograms over several months of treatment. Weight gain often leads to reduced adherence, as patients may stop taking an antipsychotic drug despite an effective response. This is increasing the risk of recurrence or continued mental illness. On the other hand, patients adhering to treatment have an increased risk of diabetes mellitus, cardiovascular diseases, and other conditions related to adiposity and overweight.
Petrascheck’s laboratory, in collaboration with Olivia Osborn’s laboratory, at the University of California, San Diego, had doubts regarding how antipsychotic drugs increase eating and weight gain. Petrascheck and his colleagues found that the brain regulates normal eating and antipsychotic overeating through distinct mechanisms. The scientists found that a drug called minocycline, approved by the FDA can counteract this excessive food. This discovery occurred when the researchers searched for a screen of 192 FDA-approved drugs that could suppress the overeating of a worm species called Caenorhabditis elegans caused by antipsychotics. The screen led them to a drug most commonly used as an antibiotic, minocycline. Further mice experiments confirmed that minocycline significantly reduced overeating induced by antipsychotics without affecting the normal appetite of the animal.
The scientists found that an increase in two molecules, called transcription factors, in an area of the brain called the hypothalamus, motivates antipsychotic-induced overeating. Minocycline in Caenorhabditis elegans and mice blocks the activation of these molecules by antipsychotics. Minocycline does not seem to affect the functioning of the antipsychotic. This means that weight gain is not inherently linked to the effectiveness of antipsychotic drugs.
The results of ongoing research in the antipsychotic field and the general obesity arena are likely to enhance the work of managing antipsychotic weight gain over the next five years. Several current initiatives investigate the phenomenology and treatment of weight gain associated with antipsychotic drugs. Therefore, in the next five years, the use of pharmacological and behavioral adjunctive treatments should be refined in order to help reduce antipsychotic weight gain.