The association between weight change and symptom reduction in the CATIE schizophrenia trial

Eric Hermes, Henry Nasrallah, Vicki Davis, Jonathan Meyer, Joseph Patrick McEvoy, Donald Goff, Sonia Davis, T. Scott Stroup, Marvin Swartz, Jeffrey Lieberman, Robert Rosenheck

Research output: Contribution to journalArticlepeer-review

68 Scopus citations


Background: Weight gain and changes in metabolic indicators associated with some antipsychotics may be related to symptom improvement and thus an unavoidable correlate of clinical benefit. Methods: Data from the CATIE schizophrenia trial comparing the effectiveness of perphenazine, olanzapine, risperidone, quetiapine and ziprasidone in a randomized, double-blind, trial over 18. months were used to evaluate the relationship between percent change in body mass index (BMI) and change in total serum cholesterol and triglycerides with the Positive and Negative Syndrome Scale (PANSS) score. Analysis of covariance for observations at 3. months and a mixed effects model for all observations up to 18. months adjusted for potentially confounding variables were used to examine these associations. Results: In both models, there was a significant association (p=0.001) between change in PANSS total score and percent change in BMI, equating to a 0.28 and 0.21 point decrease in PANSS total score (range 30-210) per 1% increase in BMI respectively. Change in BMI accounted for 3% or less of variance for change in PANSS scores. There was no evidence that the association of symptoms and weight gain differed across medications in spite of substantial differences in weight gain and other metabolic measures. Neither total serum cholesterol nor triglyceride levels displayed a significant association with change in PANSS. Conclusion: The magnitude of the relationship between change in BMI and PANSS was too small to be clinically important, indicating that switching medications to one with less metabolic risk is unlikely to result in meaningful loss of clinical benefit.

Original languageEnglish (US)
Pages (from-to)166-170
Number of pages5
JournalSchizophrenia Research
Issue number1-3
StatePublished - May 2011


  • Antipsychotic agents
  • Body mass index
  • Lipids
  • Schizophrenia
  • Treatment outcome
  • Weight gain

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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