Weight Gain From Antipsychotics
Antipsychotics are drugs that treat psychosis. If you take an antipsychotic to treat your schizophrenia, a side effect of the drug may be weight gain. This happens to many people taking this type of drug. The good news is you can manage your weight.1
What research shows about antipsychotics and weight gain
A 2022 study looked at the side effect of weight gain among different antipsychotics. Experts analyzed data from nearly 100 studies. These studies looked at 16 newer drugs and 1 older drug. Findings showed some antipsychotics caused mild weight gain, including:1
- Aripiprazole (Abilify®)
- Brexpiprazole (Rexulti®)
- Cariprazine (Vraylar®)
- Haloperidol (Haldol®)
- Lumateperone (Caplyta®)
- Lurasidone (Latuda®)
All other drugs in the studies led to greater weight gain. Researchers also found that, while you may gain weight when you first start taking an antipsychotic, weight gain tends to level off at higher doses.1
This or That
Have you experienced medication-related weight gain?
Why antipsychotics may lead to weight gain
The reason why antipsychotics cause weight gain is not fully clear. These drugs have different effects on various parts of the brain, but all of them affect a brain chemical called dopamine. This may interfere with reward signaling and lead to weight gain.1
Reward signaling in the brain allows you to feel pleasure in response to certain stimuli or behaviors. When an antipsychotic affects the dopamine system linked to reward signaling, it may disrupt the typical response to pleasurable experiences. This may trigger you to eat more than usual.1,2
Avoiding and managing weight gain from antipsychotics
There are ways to manage your weight while still treating schizophrenia with an antipsychotic.
Lifestyle changes
Building healthier habits into your day-to-day life is a way to manage weight. These habits may include:3,4
- A healthy diet. Focus on eating whole foods, and cut back on processed foods and added sugar.
- Exercise. Exercise can help control your weight while also improving your mental health. Aim for 150 minutes of aerobic exercise each week to maintain your weight. It should be moderately intense.
- Sleep. Be sure to get enough quality sleep each night. Adults should get at least 7 hours of sleep a night.
- Behavioral therapy. Work with a mental health professional to learn coping skills to deal with cravings for sweets and carbohydrates.
Medication
Prescribed drugs may be another option to help prevent weight gain when taking an antipsychotic. For example, the diabetes drug metformin may also work to treat and avoid weight gain from antipsychotics.3
One review looked at whether certain drugs can help prevent weight gain caused by antipsychotics in people with schizophrenia. Experts looked at the drugs below:5
- Metformin
- Topiramate
- Acid reducers called H2 blockers, such as famotidine
- Drugs like fluoxetine that affect a brain chemical called monoamine (monoamine modulators)
- Melatonin
- Samidorphan
Topiramate did not seem to work. Drugs that showed some promise in preventing weight gain were:5
- Metformin
- H2 blockers
- Monoamine modulators
Because of the limited quality of many studies, more research is needed on this topic.5
All drugs come with a chance of side effects. Talk to your doctor about whether drugs to avoid weight gain is right for you and whether their pros will outweigh their cons.3