Antipsychotic switching, notably to aripiprazole or ziprasidone, may lead to weight loss, while switching to olanzapine or clozapine can worsen cardiometabolic status.
Switching from a medication with a higher risk for weight gain, such as olanzapine, to one with a lower risk, such as aripiprazole or ziprasidone, can lead to significant weight loss.
Many people taking antipsychotics can lose some weight with simple changes to their diet and lifestyle. Losing even a small amount of weight can have important health benefits.
Quetiapine is a second-gen- eration antipsychotic that blocks both dopamine and serotonin (5HT) re- ceptors (3). Weight gain is a signifi- cant side effect associated with queti- apine use (4,5). Weight loss is an in- frequent adverse effect (3). Anorexia was frequently reported in premar- keting evaluations (3).
Weight gain usually results from increased appetite - a common side-effect of many atypical antipsychotic drugs - and sub- sequent excessive food consumption. Though weight gain is seen in virtually every antipsychotic, weight loss has been recorded in only few of them, especially quetiapine [16].
Seroquel (Quetiapine) is an antipsychotic drug for the treatment of various mental health disorders, like schizophrenia, bipolar disorder, and depression. Unfortunately, the antipsychotic is known for a broad range of side effects. Among the adverse effects is that it can lead to weight gain.
Quetiapine and Weight Gain
It is very common for people taking quetiapine to gain weight. Many studies show that people taking quetiapine at any dose, even the low doses used for sleep problems, gain weight. 8 The weight gain usually takes place in the first 12 weeks.
Antipsychotic-induced weight gain and metabolic effects show diurnal dependence and are reversible with time restricted feeding.
We conclude that while other xenobiotics cause unique shifts in the gut microbiome which can synergize with risperidone (Fig. 3E), risperidone alone is sufficient to reduce energy expenditure and induce weight gain.
Metformin has the most evidence of efficacy, while topiramate, sibutramine, aripiprazole and reboxetine are also effective. These drugs prevent or treat weight gain through different mechanisms.
Antipsychotic drugs, scientists showed, not only block dopamine signaling in the brain but also in the pancreas, leading to uncontrolled production of blood glucose-regulating hormones and, eventually, obesity and diabetes.
One of the most commonly reported side effects is weight gain. Over time, excess weight can harm the heart, lungs, stomach, liver, pancreas, and other organs. While many people gain weight while taking Seroquel as prescribed, the result isn't inevitable.
An analysis of 13 placebo-controlled trials of people with schizophrenia or bipolar disorder showed an average weight loss of 1.5kg in those trials using aripiprazole as monotherapy and an average weight gain of 1.7kg after 14 weeks when aripiprazole was added to ongoing antidepressant treatment.
The table below lists prescription drugs approved by the FDA for weight loss. The FDA has approved five of these drugs—orlistat (Xenical, Alli), phentermine-topiramate (Qsymia), naltrexone-bupropion (Contrave), liraglutide (Saxenda), and semaglutide (Wegovy)—for long-term use.
Second-generation antipsychotics (SGAs) have a decreased risk of extrapyramidal side effects as compared to first-generation antipsychotics.
The drugs on this curve included aripiprazole, olanzapine, risperidone, and paliperidone, in both oral and long-acting injection forms. Aripiprazole resulted in the least weight gain while olanzapine caused the most.
The SSRI fluoxetine (Prozac) and the SNRI duloxetine (Cymbalta) can lead to a decrease in appetite and slight weight loss during the first months of treatment. Bupropion (Wellbutrin), which works by blocking norepinephrine and dopamine, may also have this effect.
It should be noted that not all psychotropic drugs lead to weight-gain, and some have even been shown to decrease weight, such as serotonin-reuptake inhibitors (SSRI) during the first few weeks of use (Michelson et al.
Patients who are on these antipsychotic medications and gaining weight were also found to have elevated leptin levels [16]. Because quetiapine blocks 5HT-2C, it may cause leptin resistance at the level of the hypothalamus, contributing to increased food intake and obesity (Figure 1).
Confusion, headache, drowsiness, agitation, constipation, weight gain, dry mouth, and blurred vision. Sedation - which may affect your ability to drive or operate machinery. Avoid alcohol.
Key Points. Weight gain is more common in patients treated with valproate, olanzapine, and quetiapine than with lithium. Causes of weight gain include water retention and hypothyroidism, which can be treated with diuretics and levothyroxine. Gastrointestinal side effects can lead to ending lithium trials.
Weight gain is possible while taking atypical antipsychotics, including quetiapine. In clinical studies, up to 23% of people taking quetiapine for schizophrenia gained 7% or more of their body weight. A similar number of people taking it for bipolar mania experienced the same amount of weight gain.
Weight gain was more prominent with olanzapine: 36% of the patients had a weight gain of > 5% from baseline, compared with 17% of the risperidone patients and 13% of the quetiapine patients (Sachetti et al, 2003). The present study had similar results.