Weight Gain, Obesity, and Psychotropic Prescribing

Abstract

A majority of psychiatric medications are known to generate weight gain and ultimately obesity in some patients. There is much speculation about the prevalence of weight gain and the degree of weight gain during acute and longitudinal treatment with these agents. There is newer literature looking at the etiology of this weight gain and the potential treatments being used to alleviate this side effect. The authors undertook a comprehensive literature review in order to present epidemiology, etiology, and treatment options of weight gain associated with antipsychotics, mood stabilizers, and antidepressants.

Bariatric surgery: a viable treatment option for patients with severe mental illness

“…Second generation antipsychotics (e.g., clozapine, olanzapine) (18) as well as mood stabilizers (e.g., valproic acid, lithium) (19) can result in significant weight gain. While education on nutrition and weight loss is necessary, (20) bariatric surgery offers an additional tool for these patients to avoid health complications due to weight gain.…”

Beyond Pharmacotherapy: Understanding the Links between Obesity and Chronic Mental Illness

“…[9][10][11] In addition to iatrogenic effects, the association between obesity and severe and persistent mental illness involves several other moderating and mediating factors. The complex interplay between psychiatric illness and weight involves neurobiology, psychology, and sociological factors.…”

Medical Assessment and Preparation of Patients Undergoing Bariatric Surgery

“…Antihistaminergic effect by most psychotropic medications including anti-depressants and anti-psychotics causes cravings for carbohydrate (Davtyan and Ma 2008;Nihalani, Schwartz et al 2011). Antipsychotics cause inhibitory effect on serotonin and epinephrine receptors thus stimulating appetite (Davtyan and Ma 2008).…”

“…Antipsychotics cause inhibitory effect on serotonin and epinephrine receptors thus stimulating appetite (Davtyan and Ma 2008). These effects could cause 2 to 17kg of weight gain during treatment (Nihalani, Schwartz et al 2011). Lithium is used as mood stabilisers and might cause weight gain through increasing level of serum leptin (Atmaca, Kuloglu et al 2002) or changes in thyroid function.…”

“…Beta adrenergic receptors are present in adipose tissue and when stimulated by noradrenaline, help to metabolize fat into energy source (Nihalani, Schwartz et al 2011). Beta blocker not only reverses this effect, it also causes reduction in resting metabolic rate (Davtyan and Ma 2008).…”