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Dr. Bob is Robert Hsiung, MD,
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Posted by Iansf on September 28, 2005, at 11:34:06
Amantadine Curbs Weight Increase in Patients Taking Olanzapine
Reuters Health Information 2005. © 2005 Reuters Ltd.
Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.NEW YORK (Reuters Health) Sept 16 - Amantadine may help stabilize weight in psychiatric patients taking the antipsychotic olanzapine, researchers report in the September issue of the American Journal of Psychiatry.
Dr. Karen A. Graham and colleagues from the University of North Carolina, Chapel Hill,
note that weight gain "is the most important tolerability issue" for second-generation antipsychotics.
To investigate whether amantadine might combat such weight increase, the researchers
randomized 21 psychiatric patients who had gained at least 5 lb with olanzapine to also receive amantadine or placebo. The researchers assessed body mass index (BMI), psychiatric status, and fasting blood levels at baseline and at 12 weeks.
The median length of treatment with olanzapine prior to study entry was 7 months. Baseline BMI was 32.9 in the amantadine group and 31.8 in the placebo group. Three patients in the amantadine group and none in the placebo group withdrew from the study.
Significantly fewer patients in the amantadine group gained weight compared to the placebo group. The amantadine patients lost a mean of 0.8 lb and had a mean drop in BMI of 0.07, the placebo patients gained a mean of 8.7 lb and had a BMI increase of 1.24.
The effect remained significant after controlling for BMI and length of olanzapine treatment before study entry. Overall, weight stabilization or loss was seen in 8 (67%) of 12 amantadine-treated patients and 2 (22%) of the 9 placebo-treated subjects.
The researchers note that the mechanism by which amantadine stabilizes weight is unknown, but that prevention of antipsychotic-related obesity is critical.
"Investigation of the use of amantadine started concurrently with antipsychotic medication," they conclude, "is imperative."
Am J Psychiatry 2005;162:1744-1746.
Posted by iforgotmypassword on September 28, 2005, at 11:48:24
In reply to Amantadine stabilizes weight, posted by Iansf on September 28, 2005, at 11:34:06
i've read of so many properties to it, some conflicting.
that it is:
-an antiviral
-an NMDA antagonist
-a dopaminergic drug (and a norandrenrgic and serotenergic drug as well, according to an article on biopsychiatry.com, i think)what else does it do? or more importantly what does it actually do potently and effectively at prescribed doses?
Posted by Phillipa on September 28, 2005, at 18:37:15
In reply to amantadine is such a mysterious drug., posted by iforgotmypassword on September 28, 2005, at 11:48:24
Does amantadine have another name? Fondly, Phillipa
Posted by iforgotmypassword on October 1, 2005, at 21:07:26
In reply to Re: amantadine is such a mysterious drug., posted by Phillipa on September 28, 2005, at 18:37:15
Posted by jerrympls on October 2, 2005, at 2:05:37
In reply to Amantadine stabilizes weight, posted by Iansf on September 28, 2005, at 11:34:06
Interesting. I wonder if it would help me lose some of this 100 pound weight gain that Seroquel caused?
Posted by Iansf on October 2, 2005, at 17:54:46
In reply to Re: Amantadine stabilizes weight, posted by jerrympls on October 2, 2005, at 2:05:37
> Interesting. I wonder if it would help me lose some of this 100 pound weight gain that Seroquel caused?
This particular study looked only at weight stabilization rather than weight loss. It does suggest that if you start taking amantadine at the first sign of weight gain, you might be able to prevent further gain.
I have, however, seen other studies indicating amantadine can be used to help lose weight - and also reduce depression. I'll see if I can find the studies.
Posted by Iansf on October 2, 2005, at 18:07:51
In reply to Re: Amantadine stabilizes weight, posted by Iansf on October 2, 2005, at 17:54:46
So far the only amantadine studies I've found indicate weight stabilization but not weight loss. HOWEVER, I did find the following on metformin, a drug usually used to treat diabetes. Read through to the end for some especially interesting info re mood disorders:
A possible new entry in the "antidote" group is Glucophage (metformin). We have much less experience with this medication in this role, but tons of experience with it overall -- it's been a standard medication for diabetes for years. It does not lower blood sugar directly, so lowering your blood sugar "too far" using this medication is not a problem. It directly reverses on of the possible ways that Depakote and Zyprexa cause weight gain, through something called "metabolic syndrome". Too bad Glucophage is a little tricky to use: it causes diarrhea in about 50% of people who take it, although if you start low enough and go up slowly enough you are much more likely to avoid this problem.
However, there is one small "open trial" (no control group) which showed that adding Glucophage to Zyprexa, or Depakote, or Risperidone, was enough to cause 15 of the 19 kids who had gained weight on those agents to start losing weight. In most of the kids it was a substantial and sustained weight loss. And there's perhaps -- just perhaps -- one more reason to think that this "antidote" strategy with Glucophage might be a good thing.
As you'll see in the "metabolic syndrome" story, there is a sliver of evidence (so far; this is just becoming an active area of research) that Glucophage could actually treat mood symptoms somewhat similar to what we see mood stabilizers do for mood. If this was true, then we'd have here a medication that not only could prevent and reverse metabolic syndrome, it might actually be a "treatment" itself for mood symptoms. So far it looks much easier to tolerate in the long run than topiramate. I've even had a patient improve on it and then able to stop the Glucophage, while staying on Depakote at a lower dose than originally caused her weight gain, without a return of weight gain. That would be a great trick if we can get this result frequently with this medication! But, be aware that this approach is almost completely unresearched, so your doctor virtually certain to be unaware of all this. Iif she/he is hesitant about considering this approach, because of the lack of research, be aware that such hesitation is generally wise position to be taking at this stage.Source: PsychEducation.org, website of Jim Phelps, M.D.
Posted by jerrympls on October 6, 2005, at 12:26:55
In reply to Re: weight, posted by Iansf on October 2, 2005, at 18:07:51
> So far the only amantadine studies I've found indicate weight stabilization but not weight loss. HOWEVER, I did find the following on metformin, a drug usually used to treat diabetes. Read through to the end for some especially interesting info re mood disorders:
>
> A possible new entry in the "antidote" group is Glucophage (metformin). We have much less experience with this medication in this role, but tons of experience with it overall -- it's been a standard medication for diabetes for years. It does not lower blood sugar directly, so lowering your blood sugar "too far" using this medication is not a problem. It directly reverses on of the possible ways that Depakote and Zyprexa cause weight gain, through something called "metabolic syndrome". Too bad Glucophage is a little tricky to use: it causes diarrhea in about 50% of people who take it, although if you start low enough and go up slowly enough you are much more likely to avoid this problem.
> However, there is one small "open trial" (no control group) which showed that adding Glucophage to Zyprexa, or Depakote, or Risperidone, was enough to cause 15 of the 19 kids who had gained weight on those agents to start losing weight. In most of the kids it was a substantial and sustained weight loss. And there's perhaps -- just perhaps -- one more reason to think that this "antidote" strategy with Glucophage might be a good thing.
> As you'll see in the "metabolic syndrome" story, there is a sliver of evidence (so far; this is just becoming an active area of research) that Glucophage could actually treat mood symptoms somewhat similar to what we see mood stabilizers do for mood. If this was true, then we'd have here a medication that not only could prevent and reverse metabolic syndrome, it might actually be a "treatment" itself for mood symptoms. So far it looks much easier to tolerate in the long run than topiramate. I've even had a patient improve on it and then able to stop the Glucophage, while staying on Depakote at a lower dose than originally caused her weight gain, without a return of weight gain. That would be a great trick if we can get this result frequently with this medication! But, be aware that this approach is almost completely unresearched, so your doctor virtually certain to be unaware of all this. Iif she/he is hesitant about considering this approach, because of the lack of research, be aware that such hesitation is generally wise position to be taking at this stage.
>
> Source: PsychEducation.org, website of Jim Phelps, M.D.
>
Interesting - because my doc wanted me to go on Metformin to reduce the wieght caused by Seroquel - however, I couldn't tolerate it as it caused the most painful intestinal cramps ever!
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