These results provide further support for a dysfunction in cortical-limbic circuitry in depression, which is at least partly reversed after successful paroxetine treatment.

(Weight clas si fi ca tion by BMI is shown in Ta ble 1.) These preva lence sta tis tics re flect a rapid tra jec tory of change over the past 20 years (4). Obe sity increases the risk for a myr iad of medi cal dis or ders, some forms of can cer, and all-cause mor tal ity (1,5).Re ports of weight gain in duced by con ven tional an tipsy chotics (CAPs, for ex am ple, chlor pro maz ine) be gan to ap pear soon af ter their avail abil ity (6,7). Atypi cal an tipsy chot ics (AAs, for ex am ple, risperi done, ol an zap ine, queti apine, clozap ine) of fer en hanced ef fi cacy in the treat ment of psy chotic dis or ders and are rec om mended as a first-line phar ma cothera peu tic strat egy for schizo phre nia (8). Al though AAs offer an im proved neu ro logi cal side-effect pro file, sev eral AAs ap pear to pos sess greater weight gain li abil ity than CAPs.Antipsychotic-induced weight gain has been de scribed as highly dis tress ing to pa tients, ad versely af fect ing selfesteem, and, al though dif fi cult to quan tify, de creas ing treatment ad her ence (9).The es ti mated preva lence of obe sity among per sons with schizo phre nia con verges with and may ex ceed that of the gen eral popu la tion (10). Fur ther, chronic psy chi at ric pa tients ex hibit high rela tive rates of ad verse health be hav iours (such as smok ing) and sev eral medi cal dis or ders (11).This re view sum ma rizes AA-induced weight gain and the poten tial im pact of these agents on the glu cose ho meo static network and lipid mi lieu. Weight Gain: Comparative LiabilityAntipsychotic-induced weight gain is of ten re ported in an idio syn chra tic man ner. Most authors re port an ab so lute weight change; less re ported, but per haps more clini cally rele vant, are meas ure ments such as weight gain greater than or equal to 7% from base line or pe riph eral ver sus cen tral

In this pilot, open-label cross-sectional study, valproate-treated females exhibited higher rates of menstrual abnormalities and biochemical evidence of both hyperandrogenism and adverse metabolic parameters when compared with lithium-treated females. These preliminary data suggest that valproate may, in some predisposed females, adversely impact upon the reproductive endocrine milieu and result in aspects of the metabolic syndrome.

These preliminary data suggest that adjunctive topiramate may reduce depressive symptom severity in acute bipolar depression. The antidepressant efficacy of this compound requires confirmation via double-blind placebo controlled investigation.

No abstract