Open Access

Alkomiet Hasan

• Antipsychotic-induced weight gain (AIWG) is a common adverse effect associated with the use of antipsychotics. The complications associated with this adverse effect, such as type 2 diabetes mellitus, cardiovascular diseases, and oncological diseases, account for part of the excess mortality in schizophrenia. High-risk agents are clozapine and olanzapine, but quetiapine, risperidone, and paliperidone are also problematic in this regard. In most cases, a dose reduction or switching of the antipsychotic is not possible. For these reasons, add-on treatment with metformin, when non-pharmacological interventions were not effective or feasible, is now the gold standard in the treatment of AIWG. This constitutes an off-label treatment. The GLP-1 receptor agonists (GLP-1 analogs) are also gaining importance in AIWG, but at present they are certainly not yet recommended for routine use. Further options for the management of AIWG are the administration of topiramate or an add-on administration ofAntipsychotic-induced weight gain (AIWG) is a common adverse effect associated with the use of antipsychotics. The complications associated with this adverse effect, such as type 2 diabetes mellitus, cardiovascular diseases, and oncological diseases, account for part of the excess mortality in schizophrenia. High-risk agents are clozapine and olanzapine, but quetiapine, risperidone, and paliperidone are also problematic in this regard. In most cases, a dose reduction or switching of the antipsychotic is not possible. For these reasons, add-on treatment with metformin, when non-pharmacological interventions were not effective or feasible, is now the gold standard in the treatment of AIWG. This constitutes an off-label treatment. The GLP-1 receptor agonists (GLP-1 analogs) are also gaining importance in AIWG, but at present they are certainly not yet recommended for routine use. Further options for the management of AIWG are the administration of topiramate or an add-on administration of aripiprazole. This article presents the causes, the diagnostic approach, and the management of AIWG…