Metabolic Effects of Antipsychotic Medications

Comparative Metabolic Effects

Both medications are identified as having poor cardiometabolic profiles, but recent evidence indicates clozapine has the worst metabolic profile overall, according to the American College of Psychiatry 1, 2

Patients on either medication require comprehensive monitoring, including baseline and regular measurements of BMI, waist circumference, blood pressure, as recommended by the American Psychiatric Association 1
Fasting glucose checks at baseline, 4 weeks after initiation, and regularly thereafter are necessary for patients on these medications, as suggested by the American Diabetes Association 1
HbA1c, lipids, liver function tests at baseline and periodically are required for patients on these medications, according to the National Institute of Mental Health 1

Lifestyle modifications, such as diet, physical activity, and tobacco cessation, may be beneficial for patients developing metabolic syndrome while on these medications, as recommended by the American Heart Association 1
Adjunctive metformin may be considered for patients developing metabolic syndrome while on clozapine, as suggested by the American College of Clinical Pharmacology 2
GLP-1 receptor agonists may be beneficial as adjunctive treatment for patients with metabolic issues related to antipsychotic use, according to the Endocrine Society 1