Do antipsychotics cause weight gain?

Is weigh gain a side effect of antipsychotics?

Yes, antipsychotics are associated with weight gain in patients. Weight gain is a relatively common side effect of antipsychotic use and can be problematic for patients. Weight gain and obesity lead to cardiovascular dysfunction, cerebrovascular morbidity, premature mortality, and an overall reduced quality of life. ^[1]

People can experience weight gain after beginning their course of antipsychotics and continue to gain more and more weight in the long term. ^[1] Children are particularly susceptible to antipsychotic-induced weight gain. ^[1]

Weight gain is the consequence of taking in more calories from food and drink than are used up by the body. It can be helpful to structure calorie intake and expenditure in a per diem format. Any extra calories consumed on top of the amount used per day are stored as body fat. ^[2]

The primary way antipsychotics increase weight gain is by stimulating appetite in patients, so they consume more food. ^[2] Many people report craving sweet or fatty foods when on antipsychotics. ^[2]

Appetite is regulated by a portion of the brain called the hypothalamus. The hypothalamus integrates information it receives from other parts of the brain and gut-related hormones, such as leptin and ghrelin. ^[2] Antipsychotics appear to block neurotransmitter receptors in the brain, which is thought to play a part in stimulating appetite and subsequent weight gain. ^[2]

It's important to note that not everyone who takes antipsychotic medications will experience significant weight gain. Some individuals may experience minimal changes in weight, while others may experience more substantial weight gain. The risk of weight gain varies from one medication to another.

If weight gain is a concern for you, it's crucial to discuss it with your healthcare provider before starting or adjusting any medication.

What antipsychotics are associated with weight gain?

Second-generation antipsychotics, also known as atypical antipsychotics, are primarily associated with weight gain – although, other antipsychotics can also cause weight gain. ^[3]

Examples of second-generation antipsychotics associated with weight gain include:

1. Olanzapine (Zyprexa): Olanzapine is a second-generation (atypical) antipsychotic known for its significant potential to cause weight gain. It's often associated with substantial increases in appetite and metabolic changes.
2. Clozapine (Clozaril): Clozapine is another atypical antipsychotic that can lead to significant weight gain. It's often used in treatment-resistant schizophrenia but is associated with a higher risk of metabolic side effects.
3. Quetiapine (Seroquel): Quetiapine is an atypical antipsychotic that can lead to weight gain, especially at higher doses. It's sometimes prescribed for schizophrenia, bipolar disorder, and major depressive disorder.
4. Risperidone (Risperdal): Risperidone is another atypical antipsychotic that has been linked to weight gain, though the extent of this effect may vary among individuals.
5. Paliperidone (Invega): Paliperidone, a metabolite of risperidone, is used for schizophrenia and related disorders. It can also contribute to weight gain, especially in high doses.

Aripiprazole is considered an atypical antipsychotic with a lower risk of weight gain compared to some others. ^[1] It's often prescribed due to its favorable side effect profile. ^[1]

Amisulpride and ziprasidone are also associated with lower levels of weight gain than other atypical antipsychotics. ^[1]

What strategies can be used to negate antipsychotic-induced weight gain?

Managing antipsychotic-induced weight gain involves a combination of strategies, including lifestyle changes, medication adjustments (if appropriate), and ongoing monitoring from your healthcare provider.

• Eat healthily: Focus on a balanced diet rich in whole foods, including fruits, vegetables, lean proteins, whole grains, and healthy fats. Avoid excessive consumption of sugary foods, refined carbohydrates, and high-calorie snacks. Pay attention to portion sizes and consider using smaller bowls or plates to reduce the likelihood of
• Regular exercise: Engage in regular physical exercise, such as walking, jogging, swimming, or dancing. Aim for at least 150 minutes of moderate-intensity aerobic activity per week, along with muscle-strengthening activities.
• Cognitive or behavioral intervention: Cognitive-behavioral therapy (CBT) can help address overeating and emotional eating by focusing on identifying triggers and developing healthy coping strategies. ^[1]
• Switching medication: Discuss the possibility of adjusting your medication with your healthcare provider. They might consider switching to a different antipsychotic that has a lower likelihood of causing weight gain, such as amisulpride, ziprasidone, or aripiprazole. ^[1]
• Social support: Participating in support groups or receiving counseling can provide emotional support and help you navigate the challenges of managing weight gain.

Remember that managing side effects related to antipsychotics, including weight gain, can feel much easier if you have a dedicated support system in place. Therapy, social support, and an open communication channel with your healthcare provider can help you manage any side effects brought on by your course of antipsychotics.

Do not cut back on any prescribed medications without speaking with your doctor first. Doing so can lead to relapse or initiate the onset of withdrawal symptoms, setting you back in terms of your treatment and reducing your overall quality of life.