Study (year) |
Type of study |
Level of evidence |
Outcomes |
Ref. |
Atypical antipsychotics |
Allison et al. (1999) |
A meta-analytic study of 81 treatment trials (18 had placebo comparisons) |
I |
Clozapine posed the highest risk of patient weight gain, followed by olanzapine and quetiapine |
[43] |
Schneider et al. (2006) |
Randomized double-blinded clinical trial |
I |
6–11% of patients (0.4–1 lb per month) were noted to have a cumulative weight gain of more than 7% |
[39] |
Lipkovich et al. (2007) |
Post hoc analysis of 1267 patients |
II-3 or III if the result is very significant |
Gaining more than 7% of initial bodyweight was significantly greater in patients treated with olanzapine, vs 296 patients who received another comparator drug (risperidone or a conventional antipsychotic drug) |
[36] |
Sitburana et al. (2008) |
Case–controlled study involving 28 Alzheimer's disease patients |
II-2 |
BMI for 28 Alzheimer's disease patients on atypical antipsychotics increased 0.01 kg/m2/month |
[45] |
Mathys et al. (2009) |
A retrospective chart review at a Veterans Affairs Medical Center |
III |
Weight gain (≥7% of baseline weight) occurred in 8.92% of the 56 eligible elderly patients |
[44] |
Albert et al. (2009) |
A retrospective chart review |
III |
The study found that 20 subjects (13%) gained more than 5% of bodyweight, whereas 49 (32%) lost more than 5% of bodyweight |
[35] |
Dronabinol |
Volicer et al. (1997) |
A randomized, double-blind, placebo-controlled crossover design study |
I |
Patients' bodyweight increased more during the dronabinol treatment than during the placebo periods |
[57] |
Wilson et al (2007) |
A 2007 retrospective observational study |
III |
15 subjects (53.5%) on dronabinol gained weight, of which 10 (67%) gained more than 5 lbs and 6 (40%) gained more than 10 lbs |
[58] |
Megestrol acetate |
Karcic et al. (2002) |
Retrospective chart review |
III |
With megestrol acetate treatment, all of the nutritional parameters improved (p < 0.05) |
[106] |
Yeh et al. (2000) |
A randomized, double-blind, placebo-controlled trial |
I |
3 months after treatment concluded, weight gain was significantly increased in patients treated with megestrol acetate |
[59] |
Sullivan et al. (2002) |
Prospective observational study |
II-2 |
Nursing home residents who received appetite stimulants (12% of the sample) were 70% more likely than their counterparts to gain weight |
[60] |
Simmons et al. (2004) |
Nonrandomized clinical trial |
II-2 |
Megestrol acetate had a significant positive effect on patient food and fluid intake when the patient also received optimal meal time feeding assistance |
[63] |
Reuben et al. (2005) |
A randomized, placebo-controlled clinical trial |
I |
After 20 days, the 800-mg treatment group's appetite was better than at baseline (p = 0.04) and at the 42-day point, the 400-mg treatment group's appetite at the start of the last meal was better than at baseline (p = 0.02) |
[64] |
Sullivan et al. (2007) |
A randomized, double-blind/single-blind, placebo-controlled study |
I |
These results suggest that weight gain with megestrol acetate is correlative to an increase in body fat |
[65] |
Bodenner et al. (2007) |
Retrospective case–controlled cohort study |
II-2 |
Megestrol acetate treatment of elderly nursing home residents with significant weight loss was associated with a significant increase in all-cause mortality without a significant increase in weight |
[107] |
Mirtazapine |
Goldberg (2002) |
Retrospective chart review |
III |
The study concluded that elderly depressed patients, including those with dementia, are equally likely to gain weight with mirtazapine or sertraline when treated over a 4-month period |
[75] |
Schatzberg et al. (2002) |
A randomized, double-blind study |
I |
Mirtazapine produced modest increases from baseline in mean bodyweight, whereas paroxetine was associated with slight decreases from baseline in mean bodyweight |
[76] |
Mihara et al. (2005) |
Retrospective cohort study |
II-2 |
The impact of using mirtazapine on weight was not statistically different from other nontricyclic antidepressants |
[72] |
Cakir and Kulaksizoglu (2008) |
A 12-week open-label, prospective study |
II-3 |
A more regular patient appetite was reported by caregivers but the study showed no difference in patient weight |
[108] |
Tricyclic antidepressants |
Rigler et al. (2001) |
Retrospective cohort study |
III |
Tricyclic antidepressants do not facilitate weight gain more than other antidepressant groups |
[82] |
Ghrelin |
Cappola (2009) |
Small randomized, double-blind, pilot study |
II-1 |
The women who received the ghrelin infusion consumed 51% more calories than the placebo group, due to increased carbohydrate (p = 0.005) |
[87] |
Growth hormone |
Blackman et al. (2002) |
Randomized, double-blind placebo-controlled parallel group trial |
I |
The results showed that growth hormone increased the patient's lean body mass and decreased fat mass, whether it was administered with the sex steroids or alone |
[91] |
Chu et al. (2001) |
8-week randomized trial of recombinant human growth factors |
I |
Increased their lean body mass, albumin and hemoglobin levels |
[92] |
Ornthine oxigluatarate |
Brocker et al. (1994) |
Randomized double-blind trial |
I |
Two months after the end of treatment, the values were: nutritional status (1.7 ± 0.5 vs 1.2 ± 0.7; p < 0.001), appetite (62 ± 19 vs 47 ± 23; p < 0.001), appetite for meat (p < 0.001), and weight gain (2172 ± 1912 vs 925 ± 1652 g; p < 0.01) |
[97] |
Testosterone |
Bhasin et al. (2005) |
Randomized, double-blind, placebo-controlled study |
I |
Increase in free fat mass and leg press muscle strength from baseline |
[102] |
Chapman et al. (2009) |
Small single-center, randomized, placebo-controlled clinical trial |
II-1 |
When compared with the no-treatment group, the combined-treatment group not only had significantly fewer subjects admitted to hospital (0 compared with 5; p = 0.03), but also fewer days in hospital (0 compared with 74; p = 0.041), and a longer time to hospital admission (p = 0.017) |
[103] |
Hyde et al. (2010) |
Prospective cohort study |
II-2 |
Researchers concluded that lower free testosterone levels (odds ratio: 1.22; 95% CI: 1.05–01.42) predicted frailty |
[109] |
O'Connell et al. (2011) |
Single center, randomized, double-blind, placebo-controlled trial study |
I |
The study concluded that the effects of 6 months of testosterone treatment on muscle strength, lean mass and quality of life in frail men are not maintained at 6 months post-treatment |
[105] |