Abstract
Olanzapine (OLZ), one of the second-generation atypical antipsychotics (SGAs), has shown relative advantages in patient adherence and outcomes. However, OLZ has also been associated with a higher incidence of weight gain than most other SGAs. Excessive weight gain may in turn contribute to long-term health concerns for some individuals. Zonisamide (ZNS), a medication approved in the United States as an adjunct in the management of epilepsy, has a diverse pharmacological profile, including sodium channel blockade, monoamine enhancement, and inhibition of carbonic anhydrase. ZNS has also been reported to cause weight loss in both humans and rodents. We hypothesized that this profile might be beneficial when co-administered with OLZ. To test this hypothesis, we evaluated the effects of OLZ on body weight, as well as the pathways known to regulate feeding behavior and arousal in the Sprague-Dawley rat. As indicated via c-Fos expression, we found an OLZ-induced activation in the nucleus accumbens and orexin neurons in the lateral hypothalamus. An OLZ-associated development of hyperphagia, weight gain and elevated blood glucose in the rat was also found. These outcomes were attenuated and reversed in the presence of concomitant ZNS. These results suggest the hypothesis that ZNS may effectively treat or prevent weight gain or metabolic changes associated with the SGAs. Future studies of this combination in patients through appropriately designed human clinical studies are encouraged.
Publication types
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
MeSH terms
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Animals
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Anticonvulsants / pharmacology
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Anticonvulsants / therapeutic use
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Appetite Regulation / drug effects
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Appetite Regulation / physiology
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Benzodiazepines / adverse effects
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Benzodiazepines / antagonists & inhibitors*
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Biomarkers / metabolism
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Body Weight / drug effects
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Body Weight / physiology
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Diabetes Mellitus / chemically induced
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Diabetes Mellitus / drug therapy
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Diabetes Mellitus / physiopathology
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Female
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Hyperglycemia / chemically induced
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Hyperglycemia / drug therapy*
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Hyperglycemia / physiopathology
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Hyperphagia / chemically induced
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Hyperphagia / drug therapy*
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Hyperphagia / physiopathology
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Hypothalamic Area, Lateral / drug effects
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Hypothalamic Area, Lateral / metabolism
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Hypothalamic Area, Lateral / physiopathology
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Intracellular Signaling Peptides and Proteins / metabolism
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Isoxazoles / pharmacology*
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Isoxazoles / therapeutic use
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Neurons / drug effects
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Neurons / metabolism
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Neuropeptides / metabolism
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Nucleus Accumbens / drug effects
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Nucleus Accumbens / metabolism
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Nucleus Accumbens / physiopathology
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Obesity / chemically induced
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Obesity / drug therapy
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Obesity / physiopathology
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Olanzapine
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Orexins
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Proto-Oncogene Proteins c-fos / metabolism
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Rats
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Rats, Sprague-Dawley
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Selective Serotonin Reuptake Inhibitors / adverse effects
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Selective Serotonin Reuptake Inhibitors / antagonists & inhibitors
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Treatment Outcome
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Weight Gain / drug effects*
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Weight Gain / physiology
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Zonisamide
Substances
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Anticonvulsants
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Biomarkers
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Intracellular Signaling Peptides and Proteins
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Isoxazoles
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Neuropeptides
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Orexins
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Proto-Oncogene Proteins c-fos
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Serotonin Uptake Inhibitors
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Benzodiazepines
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Zonisamide
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Olanzapine