weight gain with antipsychotic therapy is important as a risk factor for cardiovascular events and the development of type 2 diabetes mellitus, and because it may undermine adherence to treatment
some patients gain substantial weight during treatment with atypical antipsychotics
weight gain appears to be commonest and greatest with clozapine and olanzapine; moderate with risperidone, sertindole and zotepine; and probably least with ami-sulpride and aripiprazole
weight gain is difficult to predict in the individual, but possible predictors include a good clinical response to treatment, an initial body mass index below 23kg/m2, and younger age
the possibility of weight gain needs to be discussed with the patient before starting treatment. Ideally, a drug with a low tendency to increase weight is a better choice for a patient who is already obese or prone to weight fluctuations (1)
clinicians should measure the patients' weight, height and body mass index before starting, and at intervals throughout, treatment
Reference:
Drug and Therapeutics Bulletin (2004); 42(8):57-60.
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