Olanzapine induced weight gain in patients with cancer-related cachexia

Main Article Content

Suthan Chanthawong
Jarin Chindaprasirt
Tanarak Chaiyamee
Sawanit Suwannarat

Abstract

Most cancer patients suffer from loss of appetite, early satiety, and taste changes, which are the systemiceffect of cancer and lead to cancer-related anorexia. Cancer cachexia is characterized by the clinical presentationsof weight loss (corrected for fl uid retention) and lower quality of life (QOL). The pathophysiology of cachexia involvesthe decrease of anabolic hormones and an alteration of protein, lipid, and carbohydrate metabolism. Olanzapine(OLN), an antipsychotic agent which blocks the 5-HT2, 5-HT3, D2 and H1 neurotransmitter receptor is used to treatseveral psychotic diseases with some reported side effects: sedation, weight gain, and positive metabolic effects.

Article Details

Section
Review Article

References

Allison DB, Mentore JL, Heo M, et al. Antipsychotic-induced weight gain: a comprehensive research synthesis. Am J Psychiatry 1999; 156: 1686-1696.

Ann EM, Linmarie S. Olanzapine approved for the acute treatment of schizophrenia or manic/mixed episodes associated with bipolar l disorder in adolescent patients. Neuropsychiatr Dis Treat 2010; 6: 749-766.

Boddaert MS, Gerritsen WR, Pinedo HM. On our way to targeted therapy for cachexia in cancer? Curr Opin Oncol 2006; 18: 335-340.

Braiteh F, Dalal S, Khuwaja A, et al. Phase I pilot study of the safety and tolerability of olanzapine (OZA) for the treatment of cachexia in patients with advanced cancer. J Clin Oncol 2008; 26: 196–203.

Bruce JK, Bruce RB, Julie AG, Tollefson GD. Long-term olanzapine treatment: weight change and weight-related health factors in schizophrenia. J Clin Psychiatry 2001; 62: 92-100.

Burman R, Chamberlain J. The assessment of the nutritional status, caloric intake, and appetite of patients with advanced cancer. In: Bruera E, Higginson I, editors. Cachexia-anorexia in cancer patients. Oxford, England: Oxford University Press; 1996: 83-93.

Bymaster FP, Calligaro DO, Falcone JF, et al. Radiore-ceptor binding profile of the atypical antipsychotic olanzapine. Neuropsychopharmacology1996; 14(2):87-96.

Callaghan JT, Bergstrom RF, Ptak LR, Beasley CM. Olanzapine: pharmacokinetics and pharma-codynamic profi le. Clin Pharmacokinet 1999; 37(3): 177-193.

Fumagalli F, Frasca A, Spartà M, Drago F, Racagni G, Riva MA. Long-term exposure to the atypical antipsychotic olanzapine differently up-regu-lates extracellular signal-regulated kinases 1 and 2 phosphorylation in subcellular compart-ments of rat prefrontal cortex. Mol Pharmacol2006; 69(4):1366-72.

Inui A. Cancer anorexia-cachexia syndrome: are neuropeptides the key? Cancer Res 1999; 59: 4493-4501.

Inui A. Cancer anorexia-cachexia syndrome: current issues in research and management. CA Cancer J Clin 2002; 52: 72-91.

Jatoi A, Windschitl HE, Loprinzi CL, et al. Dronabinol versus megestrol acetate versus combination therapy for cancer associated anorexia: a North Central Cancer Treatment Group study. J Clin Oncol 2002; 20: 567-573.

Kando JC, Shepski JC, Satterlee W, Patel JK, Reams SG, Green AI. Olanzapine: a new antipsy-chotic agent with effi cacy in the management of schizophrenia. Am Pharmacother 1997; 31(11): 1325-1334.

Khojainova N, Santiago-Palma J, Kornick C, Breitbart W, Gonzales GR. Olanzapine in the management of cancer pain. J Pain Symptom Manage 2002; 23: 346-350.

Krakowski M, Czobor P, Citrome L. Weight gain, metabolic parameters, and the impact of race in aggressive inpatients randomized todouble-blind clozapine, olanzapine or haloperidol. Schizophr Res 2009; 110: 95-102.

Lam DD, Garfi eld AS, Marston OJ, Shaw J, Heisler LK. Brain serotonin system in the coordination of food intake and body weight. Pharmacol Biochem Behav 2010;97(1):84-91.

Loprinzi CL, Ellison NM, Schaid DJ, et al. Controlled trial of megestrol acetate for the treatment of cancer anorexia and cachexia. J Natl Cancer Inst 1990; 82: 1127-1132.

Loprinzi CL, Kugler JW, Sloan JA, et al. Randomized comparison of megestrol acetate versus dexamethasone versus fluoxymesterone for the treatment of cancer anorexia/cachexia. J Clin Oncol 1999; 20: 567-573.

Mantovani G, Madeddu C. Cancer cachexia: medical management. Support Care Cancer 2010; 18: 1-9.

McDonagh M, Peterson K, Carson S, Fu R, Thakurta S. Drug class review: atypical antipsychotic drugs: fi nal update 3 report [online]. 2010 Jul [cited 2011 May 2]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK50583.

Moertel CG, Schutt AJ, Reitemeier RJ, Hahn RG. Corticosteroid therapy of preterminal gastroin-testinal cancer. Cancer 1974; 33: 1607-1609.

Moldawer LL, Copeland EM. Proinflammatory cytokines, nutritional support, and the cachexia syndrome: Interactions and therapeutic options. Cancer 1997; 79: 1828-1839.

National Institute of Mental Health; University of Virginia. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Olanzapine in patients with advanced cancer and weight loss [online]. 2012 Jun 14 [cited 2012 Sep 23]. Available from: http://clinicaltrials.gov/show/NCT00489593 NLM Identifier: NCT00489593.

Navari RM, Marie CB. Treatment of cancer-related anorexia with olanzapine and megestrolacetate: a randomized trial. Support Care Cancer 2010; 18: 951-956.

Plata-Salaman CR. Central nervous system mechanisms contributing to the cachexia-anorexia syndrome. Nutrition 2000; 16: 1009-1012.

Theisen FM, Haberhausen M, Schulz E, et al. Serum level of olanzapine and its N-desmethyl and 2-hydroxymethyl metabolites in child and adolescent psychiatric disorders: effects of dose, diagnosis, age, sex, smoking, and comedication. Ther Drug Monit 2006; 28(6): 750-759.

Tisdale MJ. Biology of cachexia. J Natl Cancer Inst1997; 89: 1763-1773.

Tollefson GD, Beasley CM Jr, Tran PV, et al. Olanzapine versus haloperidol in the treatment of schizophrenia and schizoaffective and schizophreniform disorder: results of an international collaborative trial. Am J Psychiatry 1997; 154: 457-465.

Tran PV, Hamilton SH, Kuntz AJ, et al. Double-blind comparison of olanzapine versus risperidone in the treatment of schizophrenia and other psychotic disorders. J Clin Psychopharmacol1997; 17: 407-417.

Willox JC, Corr J, Shaw J, Richardson M, Calman KC, Drennan M. Prednisolone as an appetite stimulant in patients with cancer. Br Med J (Clin Res Ed) 1984; 288: 27