• Home
  • Store
    • Newsletter Subscriptions
    • Multimedia Subscriptions
    • Books
    • eBooks
    • ABPN SA Courses
  • CME Center
  • Multimedia
    • Podcast
    • Webinars
    • Blog
  • Newsletters
    • General Psychiatry
    • Child Psychiatry
    • Addiction Treatment
    • Hospital Psychiatry
    • Geriatric Psychiatry
    • Psychotherapy and Social Work
  • Log In
  • Register
  • Welcome
  • Sign Out
  • Subscribe
Home » Probiotics, Dietary Fiber, and Antipsychotic Weight Gain
Research Update

Probiotics, Dietary Fiber, and Antipsychotic Weight Gain

July 3, 2023
Jeffrey Cardenas, MD
From The Carlat Psychiatry Report
Issue Links: Editorial Information | PDF of Issue

Jeffrey Cardenas, MD. Dr. Cardenas has no financial relationships with companies related to this material.

REVIEW OF: Huang J et al, Schizophr Bull 2022;48(4):850–859

STUDY TYPE: Randomized open-label single-blinded controlled trial

Olanzapine is one of the most effective treatments for schizophrenia, but weight gain on this drug is problematic. Changes in the gut microbiome are one of several mechanisms that might explain this metabolic side effect. With this in mind, investigators looked at whether probiotics could reduce weight gain on olanzapine.

The investigators conducted two 12-week open-label single-blinded randomized controlled trials. Both trials enrolled patients with first-episode schizophrenia who had recently started olanzapine. In the first study, 90 subjects were randomized to a probiotic vs placebo. In the second study, 60 subjects were randomized to a probiotic supplemented with daily fiber vs placebo. Probiotics are thought to work better when taken with a “prebiotic” such as dietary fiber. The mean age was 24 years, and the mean olanzapine dose was 18–19 mg/day. The probiotic was Bifico, which contains Bifidobacterium, Lactobacillus, and Enterococcus. The primary outcome was a change in body weight and BMI, with insulin resistance index a secondary outcome.

After 12 weeks, the subjects on probiotics had significant improvements in insulin resistance compared to placebo, but only the probiotic + fiber group had improvements in weight and BMI. Specifically, they gained 5.14 kg compared to 9.2 kg for those on placebo with olanzapine.

The main limitations of these studies were their small size and lack of double blinding. Subjects knew which treatment they were getting, but investigators did not.

CARLAT TAKE

Given the paucity of options in preventing olanzapine-induced weight gain, probiotics plus dietary fiber supplementation may be a viable preventative strategy.

General Psychiatry
KEYWORDS antipsychotics olanzapine schizophrenia supplements weight gain
    Jeffrey Cardenas, MD

    More from this author
    www.thecarlatreport.com
    Issue Date: July 3, 2023
    SUBSCRIBE NOW
    Table Of Contents
    Learning Objectives, Prescription Drugs, TCPR, July 2023
    Auvelity: A Fast-Acting Antidepressant?
    Prescription Drug Misuse
    Are Two Antidepressants Better Than One?
    Probiotics, Dietary Fiber, and Antipsychotic Weight Gain
    Brexpiprazole Dosing in Major Depression
    CME Post-Test, Prescription Drugs, TCPR, July 2023
    DOWNLOAD NOW
    Featured Book
    • PB4e_Cover2.png

      Psychiatry Practice Boosters, Fourth Edition (2023)

      Teaches you the key points of 63 of the most clinically relevant studies in psychiatry.
      READ MORE
    Featured Video
    • therapist_canstockphoto9201097.jpg
      General Psychiatry

      Using SAMe In Clinical Practice with Garrett Rossi, MD

      Read More
    Featured Podcast
    • canstockphoto6759394.jpg
      General Psychiatry

      Throwback Thursday: Brief Therapy for ADHD

      You started a stimulant medication for a young woman with ADHD. When she returns her symptoms are 70% better, but what can we do about the rest? Today a conversation with...

      Listen now
    Recommended
    • Approaches to Autism Intervention

      January 31, 2022
      canstockphoto2240982_child-bubbles_thumb.jpg
    • Currently Available Cannabis Products

      September 1, 2022
    • Interpreting Assessment Discrepancies from Multiple Sources

      October 17, 2022
      ChildAssessment.png
    • Approaches to Autism Intervention

      January 31, 2022
      canstockphoto2240982_child-bubbles_thumb.jpg
    • Currently Available Cannabis Products

      September 1, 2022
    • Interpreting Assessment Discrepancies from Multiple Sources

      October 17, 2022
      ChildAssessment.png
    • Approaches to Autism Intervention

      January 31, 2022
      canstockphoto2240982_child-bubbles_thumb.jpg
    • Currently Available Cannabis Products

      September 1, 2022
    • Interpreting Assessment Discrepancies from Multiple Sources

      October 17, 2022
      ChildAssessment.png

    About

    • About Us
    • CME Center
    • FAQ
    • Contact Us

    Shop Online

    • Newsletters
    • Multimedia Subscriptions
    • Books
    • eBooks
    • ABPN Self-Assessment Courses

    Newsletters

    • The Carlat Psychiatry Report
    • The Carlat Child Psychiatry Report
    • The Carlat Addiction Treatment Report
    • The Carlat Hospital Psychiatry Report
    • The Carlat Geriatric Psychiatry Report
    • The Carlat Psychotherapy Report

    Contact

    info@thecarlatreport.com

    866-348-9279

    PO Box 626, Newburyport MA 01950

    Follow Us

    Please see our Terms and Conditions, Privacy Policy, Subscription Agreement, Use of Cookies, and Hardware/Software Requirements to view our website.

    © 2023 Carlat Publishing, LLC and Affiliates, All Rights Reserved.