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Atypical Antipsychotics and Weight-Gain

Posted by SalArmy4me on August 8, 2001, at 10:39:10

Journal of Clinical Psychopharmacology
Volume 19(4) August 1999 pp 316-321
Weight Gain: Side Effect of Atypical Neuroleptics?

"Marked weight gain ( >3 kg) has to be considered as a rather frequent side effect of antipsychotic medication, especially during treatment with atypical neuroleptics such as clozapine, risperidone, sulpiride, and zotepine. There is evidence that many patients with chronic schizophrenia suffer from obesity (also seen in our study), [12] which is associated with an increase of morbidity. Therefore, the weight-inducing effect of neuroleptics has to be considered particularly in long-term treatment, because the weight gain seems to be only slightly reversible without a rigorous diet. Our results show the following:

- Young subjects, previously not treated with neuroleptics, have a higher risk of weight gain, particularly if they are receiving new atypical neuroleptics. [25,26] Therefore, this side effect has to be taken seriously in view of the compliance with long-term neuroleptic medication, because as is known from the experience with lithium salt medication, weight gain is associated with a high rate of refusal of any further medication. [37]

- Atypical neuroleptics such as clozapine, risperidone, and zotepine induce a greater increase of weight and do so more frequently than do classic neuroleptics such as butyrophenone and phenothiazine derivatives. This leads to a therapeutic dilemma in planning treatment strategies for young schizophrenic patients: the high risk of weight gain during therapy with atypical neuroleptics on the one hand, and the high risk of severe extrapyramidal side effects during treatment with classic neuroleptics on the other hand. Both side effects occurring early in neuroleptic treatment can reduce patient compliance, particularly for long-term treatment..."


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