Metabolic Side Effects from Atypical Antipsychotics

Overall Metabolic Risk Profile

• The American College of Cardiology is not mentioned in this article, however, weight gain is the most common significant metabolic problem with atypical antipsychotics and can be extreme, though specific percentages vary widely by agent—ranging from approximately 2-8% of adults experiencing ≥7% weight gain in short-term trials, with substantially higher rates (up to 31-33%) for specific metabolic parameters like weight gain with clozapine 1

Specific Metabolic Parameters and Incidence Rates

• Clozapine causes weight gain in 31% of patients, representing one of its most common side effects 2
• Youth may experience even higher rates of agranulocytosis and seizures with clozapine compared to adults 2

Monitoring Requirements

• Regular clinical monitoring should occur at least every 3-6 months to identify metabolic changes early 1, 3

Polypharmacy Considerations

• Antipsychotic polypharmacy increases global side-effect burden, including higher rates of diabetes mellitus 4