Cited by 490Schizophrenia research and treatmentPharmacology and Obesity TreatmentEating Disorders and Behaviors

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Almost All Antipsychotics Result in Weight Gain: A Meta-Analysis

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Bak, Maarten, Fransen, Annemarie, Janssen, Jouke, van Os, Jim, Drukker, Marjan·2014·PLoS ONE

DOI 10.1371/journal.pone.0094112PMC PMC3998960

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Abstract

INTRODUCTION: Antipsychotics (AP) induce weight gain. However, reviews and meta-analyses generally are restricted to second generation antipsychotics (SGA) and do not stratify for duration of AP use. It is hypothesised that patients gain more weight if duration of AP use is longer. METHOD: A meta-analysis was conducted of clinical trials of AP that reported weight change. Outcome measures were body weight change, change in BMI and clinically relevant weight change (7% weight gain or loss). Duration of AP-use was stratified as follows: ≤6 weeks, 6-16 weeks, 16-38 weeks and >38 weeks. Forest plots stratified by AP as well as by duration of use were generated and results were summarised in figures. RESULTS: 307 articles met inclusion criteria. The majority were AP switch studies. Almost all AP showed a degree of weight gain after prolonged use, except for amisulpride, aripiprazole and ziprasidone, for which prolonged exposure resulted in negligible weight change. The level of weight gain per AP varied from discrete to severe. Contrary to expectations, switch of AP did not result in weight loss for amisulpride, aripiprazole or ziprasidone. In AP-naive patients, weight gain was much more pronounced for all AP. CONCLUSION: Given prolonged exposure, virtually all AP are associated with weight gain. The rational of switching AP to achieve weight reduction may be overrated. In AP-naive patients, weight gain is more pronounced.

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“For example, antidepressants [32], specifically Mirtazapine [33], and antipsychotics [34] have been linked with weight gain; selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine reuptake inhibitors (SNRI) with nausea and weight or appetite loss [35, 36].”

Authors: Bak, M., Fransen, A., Janssen, J., van Os, J., & Drukker, M.
Affiliations: Maastricht University Medical Centre (NL)
Máxima Medisch Centrum (NL)
Corresponding author: Bak, Maarten
ORCID: Bak, Maarten
Fransen, Annemarie
Drukker, Marjan
Venue: PLoS ONE
Publisher: Public Library of Science (PLoS)
Published: 2014-04-24
Volume: 9
Issue: 4
Pages: e94112
ISSN: 1932-6203 (ISSN-L)
DOI: 10.1371/journal.pone.0094112
PMC: PMC3998960
OpenAlex: W2089001223
Cited by: 490
References: 362
Citations by year: 2026: 17 · 2025: 31 · 2024: 39 · 2023: 42 · 2022: 47 · 2021: 48 · 2020: 45 · 2019: 55 · 2018: 50 · 2017: 43 · 2016: 39 · 2015: 28 · 2014: 5
FWCI: 5.28
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (unspecified)
Locations: PLoS ONE (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, other-oa)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Research Publications (Maastricht University) (publishedVersion, cc-by)
RePEc: Research Papers in Economics (submittedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Figshare (submittedVersion, cc-by)
NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
Research Publications (Maastricht University) (submittedVersion, other-oa)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Health Sciences › Medicine › Pharmacology (medical) › Pharmacology and Obesity Treatment
Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Keywords: antipsychotic drugs, weight gain, body mass index, antipsychotic switching, amisulpride, aripiprazole, ziprasidone, antipsychotic-naive patients, weight loss
MeSH terms: Bipolar Disorder, Humans, Schizophrenia, Antipsychotic Agents, Weight Gain, Body Mass Index, Overweight

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Almost All Antipsychotics Result in Weight Gain: A Meta-Analysis

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