Antipsychotic-Induced Weight Gain (AIWG)
Antipsychotic-Induced Weight Gain (AIWG)
Causes of Obesity
Patients with schizophrenia are twice as likely to be obese (with a BMI over 30) than the general population. Many factors contribute to weight gain in schizophrenia, including:
- Physical inactivity/sedentary lifestyle
- Unhealthy eating
- Effects of symptoms of mental illness
- Increased smoking
- Limited access to healthcare
- Genetics
- Other medications such as mood stabilizers and antidepressants
Comorbidities
Weight gain leads to an increased risk of cardiovascular disease, higher cholesterol, diabetes, a reduced quality of life, and poor drug compliance.
Weight Gain leads to higher incidence of:
- Heart attack and stroke
- Higher blood pressure
- Type II diabetes
- Osteoarthritis
- Sleep Apnea
- Gallbladder disease
- Respiration problems
- Some cancers
- Low self-esteem
- Lower quality of life
- Increased cholesterol
- Increased triglycerides
- Arterial hypertension
- Impaired self-image
- Low self-esteem
- Reduced social interactions
- Lower quality of life
- Reduced medication compliance contributing to increased risk of relapse
32.5% of schizophrenia patients have metabolic syndrome which contributes to a shorter life expectancy. Cardiovascular disease is the leading cause of death among patients with schizophrenia. Antipsychotics can exacerbate this risk causing a decrease in overall lifespan.
Antipsychotics
Antipsychotics affect neuropeptides associated with appetite control, energy metabolism, lipid and glucose metabolism and are prescribed for schizophrenia and manic episodes in bipolar disorder. To learn more about antipsychotic medications read our article about first and second generation antipsychotics.
Antipsychotics can cause:
- Higher blood glucose
- Increased cholesterol
- Increased triglycerides
- Increased appetite
Low potency typical (first generation) antipsychotics have moderate risk for weight gain. High potency typical antipsychotics have no weight gain but have increased risk of extrapyramidal side effects (tardive dyskinesia, Parkinsonism, akinesia, akathisia, and neuroleptic malignant syndrome).
Atypical (second generation) antipsychotic medications have a lower risk of extrapyramidal side effects, but an increased risk of weight gain. Each person reacts differently to medication and you need to work with your doctor to find the right medication to treat your symptoms, but in general, here’s how antipsychotics fair in terms of weight gain.
Significant Risk of Antipsychotic-Induced Weight Gain:
- Clozapine
- Olanzapine
Medium Risk of Antipsychotic-Induced Weight Gain:
- Paliperidone
- Quetiapine
- Risperidone
Lower Risk of Antipsychotic-Induced Weight Gain:
- Aripiprazole
- Asenapine
- Brexpiprazole
- Haloperidol
- Lurasidone
- Ziprasidone
Patients on antipsychotics typically experience rapid weight gain within the first few weeks and then continue to gain weight slowly over time until they reach a plateau. Each antipsychotic has a different plateau average. (Olanzapine tends to plateau at 4-9 months., Clozapine plateaus 42-46 months).
Weight gain also differs per patient due to age, sex, and initial BMI. For example, young patients first exposed to antipsychotics with a lower baseline weight are more likely to gain weight.
At Arch Clinical Trials, we are actively recruiting patients for two studies that are looking to reduce weight gain caused by atypical antipsychotics. Call us at 314-282-3521 if you would like to participate in a research trial.
Information for each trial below…