Almost all antipsychotics result in weight gain: a meta-analysis

Area of Science:

• Psychiatry
• Pharmacology
• Clinical Research

Background:

• Antipsychotics (AP) are known to cause weight gain, but existing reviews often focus on second-generation antipsychotics (SGA) and do not analyze duration of use.
• It is hypothesized that longer antipsychotic exposure leads to greater weight gain.

Purpose of the Study:

• To conduct a meta-analysis investigating the relationship between the duration of antipsychotic (AP) use and weight change.
• To stratify weight changes based on different durations of AP treatment and specific APs.

Main Methods:

• A meta-analysis of clinical trials reporting weight change in patients using antipsychotics (AP).
• Weight change, BMI change, and clinically relevant weight changes (≥7%) were assessed.
• Data were stratified by AP type and duration of use (≤6 weeks, 6-16 weeks, 16-38 weeks, >38 weeks).

Main Results:

• Nearly all antipsychotics (AP) led to weight gain with prolonged use, with amisulpride, aripiprazole, and ziprasidone showing minimal change.
• Weight gain varied from mild to severe across different APs.
• Switching antipsychotics did not result in weight loss for amisulpride, aripiprazole, or ziprasidone.
• Weight gain was substantially more pronounced in antipsychotic-naive patients.

Conclusions:

• Prolonged exposure to virtually all antipsychotics (AP) is associated with weight gain.
• The strategy of switching APs solely for weight reduction may be less effective than commonly believed.
• Antipsychotic-naive patients experience more significant weight gain.