title: Antipsychotic-induced weight gain in first-episode psychosis patients: a meta-analysis of differential effects of antipsychotic medications.
abstract: OBJECTIVE
  The first-episode psychosis (FEP) represents a critical period to prevent cardiovascular and metabolic morbidity decades later. Antipsychotic (AP)-induced weight gain is one modifiable factor in this period. The purpose of this study is to conduct a meta-analysis of AP-induced weight and body mass index (BMI) change in FEP.
  
  
  METHODS
  A comprehensive literature search identified 28 articles that reported data on AP-specific weight or BMI change in FEP. We conducted a meta-analysis of short- and long-term mean weight and BMI differences between placebo and AP medications. We also performed subgroup and meta-regression analysis to examine weight, BMI outcomes and their relationship with location (Asian vs. Western), sponsorship and baseline weight and BMIs.
  
  
  RESULTS
  Compared to placebo, AP-caused mean weight gain was 3.22 kg and 1.4 points BMI in the short-term, and 5.30 kg and 1.86 points BMI in the long term. Clinically significant weight gain risk increased about twofold with AP use. Weight gain was associated with duration of AP use. AP medications were associated with more weight gain in Western samples as opposed to Asian samples. Most AP medications were associated with significant body weight gain and BMI increase in FEP patients, except for ziprasidone. Olanzapine and clozapine caused the highest weight gain compared to placebo.
  
  
  CONCLUSIONS
  Except for ziprasidone, most AP medications were associated with body weight gain and BMI increase in FEP patients. Early and continuing effects of various AP medications on weight gain and BMI increase should be taken into consideration by clinicians.
authors.affiliation: Yale University Department of Psychiatry, Connecticut Mental Health Hospital, New Haven, Connecticut, USA.
authors.forename: Cenk
authors.initials: C
authors.lastname: Tek
authors.affiliation: Yale University Department of Psychiatry, Connecticut Mental Health Hospital, New Haven, Connecticut, USA.
authors.forename: Suat
authors.initials: S
authors.lastname: Kucukgoncu
authors.affiliation: Yale University Department of Psychiatry, Connecticut Mental Health Hospital, New Haven, Connecticut, USA.
authors.forename: Sinan
authors.initials: S
authors.lastname: Guloksuz
authors.affiliation: Yale University Department of Psychiatry, Connecticut Mental Health Hospital, New Haven, Connecticut, USA.
authors.forename: Scott W
authors.initials: SW
authors.lastname: Woods
authors.affiliation: Yale University Department of Psychiatry, Connecticut Mental Health Hospital, New Haven, Connecticut, USA.
authors.forename: Vinod H
authors.initials: VH
authors.lastname: Srihari
authors.affiliation: Yale University Department of Psychiatry, Connecticut Mental Health Hospital, New Haven, Connecticut, USA.
authors.forename: Aniyizhai
authors.initials: A
authors.lastname: Annamalai
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015992:Body Mass Index; D006801:Humans; D011618:Psychotic Disorders / Q000188:drug therapy*; D015430:Weight Gain / Q000187:drug effects*
chemical_list: D014150:Antipsychotic Agents
keywords: ethnicity; haloperidol; obesity; schizophrenia; side-effect