Incidence of Weight Gain and Hyper Lipidemia with a Typical Antipsychotic Treatment: A Prospective Community Based Clinical Study

Case Report

Austin J Psychiatry Behav Sci. 2014;1(1): 1001.

Incidence of Weight Gain and Hyper Lipidemia with a Typical Antipsychotic Treatment: A Prospective Community Based Clinical Study

Antony S Amaladoss1*, Christopher Balram2 and Wang A3

1Department of psychiatry and behavioral science,McMaster University, Canada

2Department of Health & Wellness, University of Prince Edward Island, Canada

3Department of Health Fredericton, University of New Brunswick, Canada

*Corresponding author: Antony S Amaladoss, Joseph Brant Memorial Hospital, Burlington, Ontario, Canada

Received: January 20, 2014; Accepted: February 24, 2014; Published: March 05, 2014


Atypical Antipsychotic (AAPS) have been found to be effective in various psychiatric conditions however evidence of treatment, emergent weight gain and hyperlipidemia limit their clinical benefits.

Objective: To determine the incidence of treatment emergent weight gain and hyperlipidemia with atypical antipsychotics.

Method: Patients with schizophrenic and non-schizophrenic conditions were randomly started on AAPS .Weight, BMI, triglycerides were measured every 3 months from the base line for one year.

121 enrolled, 119 completed the one year follow up study.

Male : 69; Female: 50; Olanzapine: 51; Risperidone: 59; Quetiapine: 8; Clozapine: 1.

Data Analysis: Descriptive and inferential analysis was carried out except Clozapine to examine the effects on weight, BMI and triglycerides.

Limitataions: Polypharmacy and ethnicity were not considered.


Mean Weight Gain:

Males: Risperidone 7.5 kg > Olanzapine 5.353 kg > Quetiapine 4.43 KG.

Females: Olanzapine 4.71 grams >Quetiapine 3.81 grams >Risperidone 3.14 kg.

Percentage of weight gain – more than 7%:

Males: Risperidone 46% > Quetiapine 33%>Olanzapine 16%

Females: Quetiapine 40% >Olanzapine 35% >Risperidone 9%



Males: Quetiapine 100%> Olanzapine 58.06%> Risperidone 51.35%

Females: Quetiapine 80%> Risperidone 50% >Olanzapine 45%


>Males: Quetiapine 33.33% >Olanzapine 32.26%> Risperidone 16.22%

Females: Risperidone 50%> Quetiapine 20% >Olanzapine 20%

Mean Triglycerides

Males: Risperidone 1.92> Olanzapine 1.7

Females: Olanzapine 1.97 > Risperidone 1.78

Percentage of Hyperlipidemia

Males: Olanzapine 54.84% >Risperidone 43.24%>Quetiapine 33.33%

Females: Quetiapine 80% > Olanzapine 65% > Risperidone 45.45%

Hyper Lipidemia Related to Age and Disease

Risperidone – Mostly seen in the 20 to 40 years age group

Olanzapine – Mostly seen in 61 years plus.

Olanzapine seems to be having more propensity to induce hyper–lipidemia in Schizophrenia and Bi–polar disorder.

Odd ratio

Olanzapine Vs Risperidone – 1.81% (S.e.(O) 0.70034827).

Conclusion: The results show that atypical antipsychotic do affect weight, BMI and Triglycerides in varying degree and in relation to age, gender and disease which has significant clinical implications that warrant close monitoring with ongoing education on life style, diet and exercise in a heuristic manner.

Introduction & Background

Patients with chronic psychiatric disorders are at increased risk for morbidity and mortality resulting from various medical diseases including respiratory diseases, infectious diseases, obesity, diabetes mellitus and cardiovascular disease [1].

In patients with schizophrenia and affective disorder the prevalence of risk factor for cardiovascular disease is approximately 1.5 to 2 times higher than the rate in the general population [2].

Mood disorders associated with obesity and it has been postulated gluco–corticoids play a central role in that role in the patho genesis ofmetabolic syndrome [3,4].

It has been evidenced all atypical antipsychotics induce weight gain and hyperlipidemia [5–7]. However, nearly all psychotropic medications induce weight gain [8–10].

The use of the atypical anti–psychotics is not confined to the treatment of schizophrenia but used to treat a broad array of other psychiatric disorders for which it has been found effective [11].

Recently there is a general consensus of varying adverse effects on weight and triglycerides with atypical antipsychotic have been proposed [12–18].

Hence this one year prospective study has been undertaken to quantify the incidence of weight gain and hyperlipidemia due to atypical anti–psychotics, which may enhance physicians in their clinical decision making.


To determine treatment effects of atypical antipsychotics on weight and triglycerides in both schizophrenic and non–schizophrenic conditions in a community setting.


Patients with schizophrenic and non —schizophrenic conditions were started randomly on atypical antipsychotics. Weight, BMI and triglycerides were measured every 3 months from the baseline for one year. There were 121 patients were enrolled in the study and 119 of them completed the one year follow up. There were 69 males and 50 females.

Treatment breakdown was as follows:

Olanzapine 51: risperidone 59: quetiapine 8: and Clozapine 1

The variables included in the analysis were

BMI– overweight is more than 25 to 29.9, Obesity is above 30

Hyperlipidemia is more than 1.7mmol⁄l.

Analysis and Interpretation

Descriptive and inferential analyses were carried out to examine the treatment effects on weight, BMI and triglycerides and in relationships to age, gender and disease. Clozapine was omitted from the analysis as there was only one patient.

The number of patients treated with Quetiapine is low compared to Olanzapine and Risperidone, yet, included as it is statistically viable, but, this needs to be taken into consideration while interpreting the results. It should be noted that polypharmacy and ethnicity were not taken into consideration.

The study reveals that more males were treated with atypical antipsychotics than females. Descriptive projection of drugs, age, gender and diagnosis can be seen in tables 1–4 & Figure 1. The age group under 19 years had been treated mostly with risperidone. A higher percentage of obesity 42.42% has been seen in schizophrenic patients and this validates the question of whether it is due to drugs or lifestyle or disease related. The mean weight gain more in females with risperidone , 7.57 kg SD 8.34 and more in females with olanzapine 4.71 kg SD 4.67.