Antipsychotic‐induced weight gain in first‐episode psychosis patients: a meta‐analysis of differential effects of antipsychotic medications

Abstract

Aim The first-episode psychosis (FEP) represents a critical period to prevent cardiovascular and metabolic morbidity decades later. Antipsychotic (AP)-induced weight gain is one modifiable factor in this period. The purpose of this study is to conduct a meta-analysis of AP-induced weight and body mass index (BMI) change in FEP. Methods A comprehensive literature search identified 28 articles that reported data on AP-specific weight or BMI change in FEP. We conducted a meta-analysis of short- and long-term mean weight and BMI differences between placebo and AP medications. We also performed subgroup and meta-regression analysis to examine weight, BMI outcomes and their relationship with location (Asian vs. Western), sponsorship and baseline weight and BMIs. Results Compared to placebo, AP-caused mean weight gain was 3.22 kg and 1.4 points BMI in the short-term, and 5.30 kg and 1.86 points BMI in the long term. Clinically significant weight gain risk increased about twofold with AP use. Weight gain was associated with duration of AP use. AP medications were associated with more weight gain in Western samples as opposed to Asian samples. Most AP medications were associated with significant body weight gain and BMI increase in FEP patients, except for ziprasidone. Olanzapine and clozapine caused the highest weight gain compared to placebo. Conclusion Except for ziprasidone, most AP medications were associated with body weight gain and BMI increase in FEP patients. Early and continuing effects of various AP medications on weight gain and BMI increase should be taken into consideration by clinicians.

Metabolic syndrome in antipsychotic naive African patients with severe mental illness in usual care

“…Asian patients were less susceptible to antipsychotic associated weight gain than patients from Western countries with a first episode of psychosis (Tek et al, 2015).…”

Weight gain during incarceration: systematic review and meta‐analysis

“…Medications used to treat some of these mental health issues (e.g. antipsychotics and antidepressants) are also known to affect weight (53)(54)(55)(56)(57). In the study by Drach et al included in the present review (26), up to 40% of those incarcerated were taking medications known to affect weight.…”

Oxidative stress in drug naïve first episode psychosis and antioxidant effects of risperidone

“…Obesity and cardiometabolic risk seem to be present early in schizophrenia (Correll et al, 2014), and most antipsychotics have been associated with body weight gain and BMI increase in FEP patients (Tek et al, 2015). However, we collected body mass index (BMI) data only in a few individuals and therefore it was not possible to analyze possible associations.…”