Weight antipsychotic-related gain

Czerwensky F, Leucht S, Steimer W (2013) MC4R rs489693 a clinical risk factor for second generation antipsychotic-related weight gain Int J Neuropsychopharmacol 16 2103-2109... 

Despite the widespread use of neuroleptics in maintenance treatment of bipolar disorder, there have not been any systematic studies of their suitability for this role. Through clinical experience it has been widely accepted that neuroleptics are useful adjunctive treatments to lithium and related drugs. Treatment refractory patients frequently respond to atypical antipsychotics such as clozapine or risperidone. Such adverse effects as EPS, cognitive dysfunction and weight gain frequently limit the long-term use of classical neuroleptics. For this reason, the atypical neuroleptics such as olanzapine and risperidone should now be considered as alternatives for maintenance treatment. 

A thorough search for studies that addressed obesity in children and adolescents in relation to the new antipsychotic drugs showed that risperidone is associated with less weight gain than olanzapine (824). 

Allison, D. B. and D. E. Casey (2001). Antipsychotic-induced weight gain a review of the literature. J Clin Psychiatry 62(Suppl 7) 22-31. Anttila, S. A. and E. V. Leinonen (2001). A review of the pharmacological and clinical profile of mirtazapine. CNS Drug Rev 7(3) 249-64. Baptista, T., N. M. Kin, S. Beaulieu and E. A. de Baptista (2002). Obesity and related metabolic abnormalities during antipsychotic drug administration mechanisms, management and research perspectives. Pharmacopsychiatry. 35(6) 205-19. 

It is believed that the weight gain observed in patients being administered typical antipsychotics is related to the antagonist action of these drugs at acetyl choline, serotonin and histamine-1 receptors. 

The clinical significance of weight gain during antipsychotic therapy is substantial. The risk of cardiovascular-related mortality is higher in individuals with schizophrenia, and this is further... 

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