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[H.sub.2]-Blocker Appears to Cut Atypical Weight Gain.

No impact on therapeutic response.

PHOENIX, ARIZ. -- Using a [histamine.sub.2] blocker may attenuate the weight gain associated with atypical antipsychotics, according to a poster presentation at the annual meeting of the New Clinical Drug Evaluation Unit sponsored by the National Institute of Mental Health.

In a double-blind, placebo-controlled study that looked at the effects of adding the [H.sub.2]-blocker nizatidine to olanzapine, weight gain was lower and was observed to plateau more quickly with the higher dose of nizatidine. The addition of the [H.sub.2]-blocker had no impact on therapeutic response or on other adverse events, said. Dr. Alan Brier of Lilly Research Laboratories, Indianapolis.

Weight gain with atypical antipsychotics--as observed in an analysis of data from a large international trial of olanzapine--can be substantial. Although patients participating in the study averaged 14 pounds of weight gain, some gained considerably more. The increase typically reaches a plateau after 9 months of treatment, the investigators noted.

The possible efficacy of an [H.sub.2]-blocker in forestalling weight gain has been suggested by case reports in which cimetidine reduced appetite and weight in healthy overweight individuals and those with type 2 diabetes mellitus.

In another report, weight gain was reduced in a patient who was given nizatidine during olanzapine treatment, he said.

Dr. Breier reported on a 16-week trial in which 132 patients were randomized to receive olanzapine with placebo, with 150 mg of nizatidine daily, or with 300 mg of nizatidine daily.

Patients who were given the higher dose of nizatidine gained significantly less weight than those who received placebo (2.76 kg vs. 5.51 kg). Differences between these groups were seen as early as the third week of treatment.

Overall, the addition of the [H.sub.2]-blocker at the higher dose seemed to shift the distribution of weight gain to the left, Dr. Breier said.

"Most patients appeared to benefit to some extent," he said.

Weight gain reached a plateau by the eighth week with the 300-mg dose of nizatidine, while it continued to the end of the trial in the other groups.

There were no differences in other adverse events (appetite increase, dizziness, somnolence, headache, dry mouth) between the groups and no difference in psychopathology Dr. Breier said.
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Title Annotation:nizatidine added to olanzapine lowered weight gain
Author:SHERMAN, CARL
Publication:Clinical Psychiatry News
Geographic Code:1USA
Date:Jul 1, 2001
Words:378
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