Drug induced weight gain, an impediment to successful pharmacotherapy: focus on antipsychotics.
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing clinical and mechanistic data without systematic methodology
PubMed 15058313 · doi:10.2174/1389450043490514
What was done
This paper reviewed mechanisms, comparative risks, and mitigation strategies for weight gain, hyperglycemia, and dyslipidemia induced by atypical and conventional antipsychotic medications.
What was found
The authors report a risk hierarchy for antipsychotic-induced body weight gain: clozapine approximately equal to olanzapine > quetiapine > risperidone > ziprasidone = aripiprazole. Proposed mechanisms include appetite stimulation correlated with H1 histaminergic and alpha1 adrenergic receptor affinities, hypothalamic-pituitary-adrenal axis activation, insulin sensitivity changes, and hyperprolactinemia. Amantadine, metformin, and reboxetine are reported to lessen weight gain. No numerical data, effect sizes, or statistical metrics are reported in the abstract.
Why it matters
It outlines relative metabolic liabilities across atypical antipsychotics to assist clinicians in drug selection, monitoring, and adjunctive metabolic management.
Limits
As a narrative review, it lacks a systematic literature search, standardized study selection, and meta-analytic pooling. No sample sizes, patient numbers, or quantitative outcome measures are provided in the abstract.
Cited by
- context Atypical antipsychotics with the suffix '-apine' promote weight gain, likely mediated by hypothalamic insulin resistance that reduces satiety signaling.