Document Type
Article
Publication Date
3-10-2025
Abstract
Purpose and Scope of Review: We discuss updates in the weight gain risk stratification of various atypical antipsychotics, dose-dependency effects, the role of the gut microbiome in the mechanism of AWIG, and the potential of GLP-1 receptor agonists and antipsychotic switching in managing and mitigating the adverse effect of weight gain. These updates are organized into 3 sections: Prediction, Mechanism, and Treatment. Recent Findings: Different atypical antipsychotics are associated with different risk profiles for weight gain, and switching from higher to lower risk antipsychotics is a promising direction for mitigating this adverse effect. Other treatments that target weight gain in general, such as lifestyle modifications and GLP-1 agonists, are also effective in managing AWIG. The dose-dependent effect of atypical antipsychotics on weight varies by patient characteristics such as age and sex as well as medication factors such as duration of treatment. These differences require further study pry. Recent insights on the mechanism of AWIG highlight the importance of alterations in the gut microbiome, neurotransmitter-receptor interactions, appetite-regulating neuropeptides and hormones, and cell-signaling molecules such as adipokines and cytokines. Summary: This review provides insight into the mechanisms by which atypical antipsychotics contribute to weight gain, the risk factors that predict the degree of AIWG, and potential treatments to manage weight gain in patients receiving therapeutic benefit from atypical antipsychotics.
Keywords
atypical antipsychotics, glp-1, samidorphan, severe mental illness, weight gain
Language
English
Publication Title
Current Cardiovascular Risk Reports
Rights
© The Author(s) 2025. This is an Open Access work distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Silas, A., Musso, M. & Dolber, T. Antipsychotic-Induced Weight Gain: What Have We Learned?. Curr Cardiovasc Risk Rep 19, 9 (2025). https://doi.org/10.1007/s12170-025-00762-z
Manuscript Version
Final Publisher Version