Reversibility of psychotropic medication induced weight gain among children and adolescents with bipolar disorders

Objective: To assess the reversibility of weight gain associated with psychotropic medications in children. Methods: A retrospective cohort study was conducted using an ambulatory electronic medical records database. Individuals under 18 years of age were identified if they were initiating a new course of second generation/atypical antipsychotics (SGA) or mood stabilizers (MS) following a bipolar disorder diagnosis and subsequently discontinued treatment within 24 months of treatment initiation. Results: Of the 297 children who had experienced positive BMI percentile increase (mean +/- SD: 8.71 +/- 11.94) during the treatment of SGA and/or MS, treatment discontinuation led to an average of 1.88 (+/- 13.41) unit decrease in BMI percentile during a 12-month period since the treatment discontinuation. Repeated measure mixed model analysis showed that the reduction of BMI percentile after treatment discontinuation was neither associated with the treatment regimens patients previously received, nor associated with time since the treatment discontinuation. The three statistically significant predictors were baseline BMI percentile, BMI percentile gained during the treatment, and comorbid substance abuse disorder. Conclusion: Children with bipolar disorder were able to lose a fraction of weight gained during pharmacotherapy after the treatment discontinuation, however, their BMI percentile may not return to the prior treatment level within a year post-medication discontinuation.