One-Year Weight Gain While on Treatment with an Antipsychotic Mean change from baseline weight 14 30 Olanzapine (12.5-17.5 mg) Olanzapine (all doses) Quetiapine Risperidone Ziprasidone Aripiprazole Amisulpride 12 25 10 20 8 Change from baseline weight (kg) Change from baseline weight (lb) 15 6 10 4 5 One-Year Weight Gain: Mean Change From Baseline Weight For the most part, antipsychotics are not used as short-term therapies. They are used as chronic therapies, principally for psychotic disorders and bipolar disorders. This graph depicts 1-year data for mean changes from baseline weight in long-term clinical trials; kilograms are on the left and the corresponding pounds are on the right of the graph.1,2 Note at the bottom of the slide that the drugs ziprasidone and aripiprazole, which produced relatively minimal short-term weight gain, produced about the same amount of weight gain long-term, or an ~1-kg mean weight gain at 52 weeks.1 Amisulpride, risperidone, and quetiapine produced an approximately 2.3-kg, 2.5-kg, and 3.6-kg weight gain, respectively, over a year.1,2 There are 2 lines for olanzapine; the first is pooling together all doses of olanzapine, from 2.5 mg up to 17.5 mg, from the pooled clinical trial data sets, resulting in a mean increase in weight at 1 year of about 6 kg or about 13 lb. For most antipsychotic therapy, 2.5 mg of olanzapine is not used. In other analyses of these data, the mean increase exceeded 22 lb, or more than 10 kg at 52 weeks. This is a clinically important increase in terms of physiologic effects.1 References: Casey DE. Metabolic issues and cardiovascular disease in patients with psychiatric disorders. Am J Med. 2005;118(suppl 2):15S-22S. Leucht S, Wagenpfeil S, Hamann J, Kissling W. Amisulpride is an "atypical" antipsychotic associated with low weight gain. Psychopharmacology (Berl). 2004;173:112-115. 2 4 8 12 16 20 24 28 32 36 40 44 48 52 Time (weeks) Adapted from Casey DE. Am J Med. 2005;118(suppl 2):15S-22S. Presented by: Dr. Marc De Hert, AEP 2007; Madrid, Spain.