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Does Concomitant Psychostimulants Mitigate Second-Generation Antipsychotics-Associated Weight Gain? An Observational
Ning Lyu1, Paul J Rowan2, Tyler J Varisco1
1College of Pharmacy, University of Houston, Houston, Texas, USA.
Journal of Child and Adolescent Psychopharmacology
|April 14, 2025
Summary
Psychostimulants may help reduce weight gain in children and adolescents taking second-generation antipsychotics (SGA). This study found that using psychostimulants concurrently or adding them later mitigated SGA-associated weight gain.
Area of Science:
- Pediatric Psychiatry
- Pharmacology
- Clinical Research
Background:
- Weight gain is a common side effect of second-generation antipsychotics (SGA).
- Psychostimulants are frequently prescribed alongside SGAs in pediatric populations.
- The impact of psychostimulants on SGA-associated weight gain requires investigation.
Purpose of the Study:
- To determine if psychostimulants mitigate weight gain in pediatric patients using SGAs.
- To compare weight changes in children and adolescents using SGAs with or without concomitant/add-on psychostimulants.
Main Methods:
- Retrospective cohort study using IQVIA Ambulatory electronic medical record-U.S. database (2016-2021).
- Identified pediatric patients (6-17 years) initiating SGAs, categorized into SGA-only, concomitant psychostimulant, and add-on psychostimulant users.
- Propensity score adjustment and linear mixed-effects regression models analyzed BMI z-score trends at 6 and 12 months.
Main Results:
- Concomitant psychostimulant users showed a significantly lower monthly BMI z-score increase compared to SGA-only users over 6 months.
- Add-on psychostimulant users also demonstrated a significantly lower rate of weight gain versus SGA-only users.
- Sensitivity analyses at 12 months confirmed these findings.
Conclusions:
- Concomitant and add-on psychostimulant use appears to mitigate SGA-associated weight gain in pediatric patients.
- Further research is necessary to evaluate the comparative effectiveness and safety of psychostimulants for managing antipsychotic-induced weight gain.
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