Educational Activity May 15, 2007

Evidence of Switching Antipsychotic Therapy to Improve Metabolic Disturbances

Peter J. Weiden, MD; John W. Newcomer, MD

J Clin Psychiatry 2007;68(5):e13

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The Journal of Clinical Psychiatry
The Primary Care Companion for CNS Disorders


Article Abstract

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Atypical antipsychotic medications are often prescribed in place of conventionalantipsychotics because these newer agents are associated with a low incidenceof extrapyramidal symptoms (EPS). However, many of the atypical antipsychoticshave adverse metabolic side effects such as substantial weight gain. Weightgain and other metabolic side effects associated with the atypical antipsychoticshave led to as high an incidence of noncompliance in patients withschizophrenia as EPS did with the older drugs. Weight gain is also associatedwith an increase in risk for diabetes, cardiovascular disease, anddyslipidemia. It is possible to reverse some of the weight gain associated withatypical antipsychotics by switching medications. Switching a patient to anappropriate low-weight-gain antipsychotic can improve weight gain and othermetabolic issues often without risking efficacy.

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