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Poyurovsky M, Fuchs C, Pashinian A, Levi A, Faragian S, Maayan R et al. Attenuating effect of reboxetine on appetite and weight gain in olanzapine-treated schizophrenia patients: a double-blind placebo-controlled study. Psychopharmacology (Berl) 192: 441-448

Research Unit, Tirat Carmel Mental Health Center, P.O. Box 9, Tirat Carmel, 30200, Israel.
Psychopharmacology (Impact Factor: 3.99). 07/2007; 192(3):441-8. DOI: 10.1007/s00213-007-0731-1
Source: PubMed

ABSTRACT Search for safe and effective strategies to diminish weight gain associated with second generation antipsychotics (SGAs) is imperative. In the present study, we sought to replicate our preliminary findings, which indicated that coadministration of the selective norepinephrine reuptake inhibitor reboxetine attenuates olanzapine-induced weight gain.
Fifty-nine patients hospitalized for first-episode DSM-IV schizophrenic disorder participated in this randomized double-blind study. Reboxetine (4 mg/day; 31 patients) or placebo (29 patients) was coadministered with olanzapine (10 mg/day) for 6 weeks. Analysis was by intention-to-treat.
Nine patients in each group prematurely discontinued the trial. Olanzapine/reboxetine-treated patients showed a significantly lower increase in body weight (mean = 3.31 kg, SD = 2.73) than their olanzapine/placebo-treated counterparts (mean = 4.91 kg, SD = 2.45). Significantly fewer olanzapine/reboxetine-treated patients gained at least 7% of their initial weight, the cutoff for clinically significant weight gain (6 [19.4%] of 31 patients vs 13 [46.4%] of 28 patients). Seven (22.6%) olanzapine/reboxetine-treated patients compared to only one patient (3.6%) in the olanzapine/placebo group revealed no weight change or even modest weight loss. Appetite increase was significantly lower in the olanzapine/reboxetine than olanzapine/placebo group and was correlated with attenuation of weight gain. Reboxetine addition was safe and well tolerated.
The results confirm that coadministration of reboxetine promotes a clinically meaningful attenuation of olanzapine-induced weight gain in schizophrenia patients. If substantiated in long-term studies, along with behavioral management and diet counseling, reboxetine may have a clinical utility in controlling SGA-induced weight gain.

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    • "Institute of Psychiatry and Clinical Sciences Centre, London, UK e-mail: oliver.howes@kcl.ac.uk associated with olanzapine treatment (Poyurovsky et al. 2007) to demonstrate improvements in triglyceride and leptin levels as well. These are important benefits if they are maintained. "
    Psychopharmacology 09/2013; 230(1). DOI:10.1007/s00213-013-3259-6 · 3.99 Impact Factor
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    • "Conversely, co-administering olanzapine with reboxetine (antidepressant and anxiolytic) resulted in significantly lower body weight increases compared with olanzapine and placebo, and patients were more likely to report substantially lower appetite increases (Poyurovsky et al. 2007). Reboxetine (selective norepinephrine re-uptake inhibitor) is assumed to stimulate NE activity, thereby diminishing olanzapine-induced weight gain (Poyurovsky et al. 2007). Olanzapine was also used to attenuate weight gain. "
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    • "Endpoint weight was significantly higher with phenylpropanolamine than with placebo (N ¼ 1, n ¼ 16; WMD ¼ 4.99 kg, CI: 2.05, 7.93) (Borovicka et al, 2002). Compared with placebo, reboxetine (Poyurovsky et al, 2003, 2007) was associated with a significant decrease in weight "
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