Aim: Long-acting injectable (LAI)antipsychotics are often used in psychosis to assist with medication compliance and relapse prevention, although the weight gain and metabolic effects in young people are yet to be examined. This study examined the long-term effects of aripiprazole and paliperidone in LAI formulation on weight gain and metabolic parameters in young people with early episode psychosis.Methods: Weight gain and other metabolic effects of aripiprazole and paliperidone in LAI formulation were examined in 59 young people with early episode psychosis over a 12-month period. Changes in outcome measurements were examined at baseline and 3 monthly intervals. Results:The results showed that both aripiprazole and paliperidone were associated with time-dependent increases in weight. At 12 months, weight increased by an average of 7% (6 kg) with both aripiprazole and paliperidone relative to the baseline, and the percentage of overweight or obese people increased from 33% to 60%.There was no advantage of aripiprazole compared to paliperidone with regards to weight change, although aripiprazole was associated with lower triglycerides and prolactin levels.Conclusions: Both LAI medications were associated with substantial weight increases over time. These results build on emerging evidence showing that aripiprazole is not weight neutral in young people. Our recommendation is that weight-management programs should be offered from the start of medication initiation.adolescents, Second generation antipsychotic medication, weight gain, youth mental health | INTRODUCTIONSecond generation antipsychotic medications can assist in the treatment of early psychosis (Galletly et al., 2016). Because of growing concerns about side-effects however (Foley et al., 2013), it can be difficult for clinicians to choose which antipsychotic agent to prescribe.Another complication is the paucity of data about long-acting injectable (LAI) antipsychotic medications that are used to assist with medication compliance. In particular, the weight gain and metabolic effects of two newer LAI antipsychotics, aripiprazole and paliperidone, in young people with early psychosis are yet to be examined. For confidence to grow regarding the safety and tolerability of these LAI in young people, it is important to further examine any potential longterm adverse health effects.

Objective: Aripiprazole is often prescribed to young people, although there remain unanswered questions about its effects on weight gain. This study undertook a meta-analysis of weight gain occurring in young people with early psychosis who were prescribed aripiprazole. Method: A systematic search was conducted for studies reporting on aripiprazole and weight change in young people with a psychotic disorder. A meta-analysis integrated the data into an estimate of effect size. Results: Eleven studies met the inclusion criteria amounting to 886 participants (mean age 18 years). The results showed significant weight gain averaging 2.7 kg. These increases were associated with a longer duration of exposure to aripiprazole but not a higher dosage. Conclusions: The results highlight the importance of regular patient monitoring and the early implementation of interventions to manage antipsychotic-related weight gain.

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