Atypical antipsychotics and weight gain--a systematic review

Area of Science:

• Pharmacology
• Clinical Psychiatry
• Evidence-Based Medicine

Background:

• Atypical antipsychotics are widely prescribed for psychiatric disorders.
• Weight gain is a common and significant side effect associated with many atypical antipsychotic medications.
• Understanding the differential impact of these drugs on body weight is crucial for patient management.

Purpose of the Study:

• To systematically review and synthesize existing data on weight changes associated with atypical antipsychotics.
• To compare the relative risk of weight gain among different atypical antipsychotic agents.

Main Methods:

• A comprehensive literature search was conducted using Medline (1980-1999) and other sources.
• Reports were identified through database searches, examination of retrieved papers, and direct contact with pharmaceutical manufacturers and clinicians.
• Data on body weight changes from 80 retrieved reports were analyzed.

Main Results:

• Eighty reports indicated changes in body weight, though data quality and measurement methods varied.
• Most reports focused on short-term weight changes.
• All atypical antipsychotics reviewed, except ziprasidone, were linked to weight increases.

Conclusions:

• Clozapine, olanzapine, and quetiapine appear to carry the highest risk of weight gain among atypical antipsychotics.
• Risperidone, sertindole, and zotepine showed a lower risk, while amisulpride had an even lower risk.
• Ziprasidone was not associated with weight gain; however, rankings are preliminary and require further investigation with longer, robust trials.