Psychiatrist.com11 Antipsychotics and Their Impact on Weight Gain By Dose

Study Reveals Different Effects of Antipsychotics on Weight Gain: Key Findings for Physicians

A new study analyzed the impact of different antipsychotic medications on weight gain, emphasizing the importance of considering dose and specific drugs for individual patients. The study provides valuable insights for physicians to make informed decisions regarding antipsychotic use.

Key Points:

• Weight gain from antipsychotics can hinder medication adherence and necessitates early consideration of strategies to manage and reduce metabolic disturbances.
• Research is ongoing to understand the causes, long-term effects, and potential solutions to antipsychotic-induced weight gain and metabolic issues.
• A meta-analysis of 52 randomized controlled trials involving 22,588 individuals revealed three distinct dose-response curves for antipsychotic medications.
• Quasi-parabolic curve: Some antipsychotics, like brexpiprazole and haloperidol, caused initial weight gain that stabilized at higher doses, indicating low weight gain and minor metabolic disturbances.
• Plateau curve: Medications in this group, including asenapine and quetiapine, showed weight gain up to a certain point but did not increase further with higher doses. Quetiapine was associated with significant metabolic alterations even at low doses.
• Ascending curve: Drugs such as olanzapine and paliperidone demonstrated weight gain that continued to increase with higher doses. Aripiprazole resulted in the least weight gain, while olanzapine caused the most.
• Ghrelin, a hormone responsible for appetite stimulation, plays a role in antipsychotic-induced weight gain. Olanzapine and clozapine have the highest risk of metabolic syndromes, while lurasidone may have a more favorable profile, although potentially with reduced efficacy for positive symptoms.