Our April Researcher in Focus is Dr. Karen Conlan, a clinical psychiatrist working in the Autism and Related Neurodevelopmental Disorders Research Group at Trinity College Dublin and the Obesity Immunology Research Group at Maynooth University. She is funded through the National Children’s Research Centre Clinical Research Fellowship for her project “The Antipsychotics and Inflammation Study (InflammAP study)”. Karen is investigating the reasons behind why anti-psychotics drugs that are used to treat various mental health disorders are associated with weight gain and obesity.
The global obesity epidemic is a leading preventable cause of premature death and poor health. In Ireland, two thirds of adults and a quarter of children are either overweight or obese. This can cause long term health problems. As Karen explains “Obesity is linked to many complications including diabetes, heart disease, autoimmune conditions and many common cancers. These contribute to early death and significantly reduce quality of life”.
Children with mental health disorders are at increased risk of weight gain and obesity related health problems. The treatment of child mental health disorders typically combines a range of approaches, including psychotherapy, psychoeducation and medication where required. As Karen explains “Some medications, particularly second-generation antipsychotics used to treat mental health disorders are associated with significant side-effects. These include weight gain and obesity which increase a child’s risk of chronic disease such as type II diabetes and heart disease in later life. These adverse effects further increase risk of cardiovascular disease in an already highly disadvantaged group who are less likely to eat a broad healthy diet or engage in exercise and activity”.
Currently, it is not possible for doctors to predict which patients will develop these side effects of weight gain from antipsychotic medication. However, previous research has suggested that weight gain is caused by the development of a persistent low-grade inflammatory state. In her study, Karen and her PhD supervisors (Prof. Louise Gallagher and Prof. Jane McGrath; TCD) have partnered with experts in obesity and inflammation (Dr. Andy Hogan; Maynooth University and Prof. Donal O’Shea, UCD) to study markers of inflammation in children with mental health disorders before and after the start of treatment with anti-psychotic medications. “In this study, we have partnered with experts in obesity and inflammation to identify factors that increase risk of weight gain, obesity and metabolic changes in patients in response to antipsychotic medication. We will test if these factors help to predict which young people are most at risk. We also hope to identify potential targets in order to prevent these side effects from occurring”.
As part of the study, Karen collects blood samples from children on antipsychotic medication and measures the levels of a wide array of molecules associated with inflammation. Karen then looks at the association between changes in these inflammatory biomarkers and weight gain. This will help to determine the factors that are most predictive of weight gain during treatment. As she explains “This is a novel study and we have shown how antipsychotics cause changes in the inflammatory profile of children and we are investigating how these inflammatory changes occur which will potentially allow us to prevent these side effects from happening. This study provides a model for understanding the metabolic complications of antipsychotic medications. Ultimately this will lead to better guidelines for doctors and patients to reduce their risks. Further studies could then be undertaken to find additional approaches to manage weight and obesity for young people on antipsychotic medications in the future. If we can understand how these drugs cause weight gain, then we can possibly implement strategies to prevent it from occurring”.
Karen would like to thank the NCRC and CMRF for funding this research project. “I would like to thank the NCRC and the CMRF for supporting paediatric research with the Clinical Research Fellowship award. Without this award, I would not be able to work in research full-time and this fellowship allows me to dedicate all my time to this research project. I feel extremely fortunate to have received a Clinical Research Fellowship award and I intend to use the experience and skills I have gained in the future to supervise researchers and trainees in psychiatry to benefit the health of children with mental health disorders”.
Additional information on Karen’s research can be found through the following links:
Twitter: @ConlanKarenM, @OSheaHoganLab, @AutismTCD