This toolbox provides a summary in tabular form of the various metabolic changes that may be caused by atypical antipsychotics. Included here are: average changes in weight both short and long term (Table 1), average change in lipids short term (Table 2), average change in lipids long term (Table 3), average changes in fasting glucose short and long term (Table 4), and a ranking of the propensity of the atypical antipsychotics to cause metabolic changes (Table 5).

Table 1.

Effect of atypical antipsychotics on weight in adult patients with schizophrenia or bipolar disorder in short and long-term placebo-controlled trials as reported in manufacturer prescribing information.1–10 

Effect of atypical antipsychotics on weight in adult patients with schizophrenia or bipolar disorder in short and long-term placebo-controlled trials as reported in manufacturer prescribing information.1–10
Effect of atypical antipsychotics on weight in adult patients with schizophrenia or bipolar disorder in short and long-term placebo-controlled trials as reported in manufacturer prescribing information.1–10
Table 2.

Effect of atypical antipsychotics on lipid profile in patients with schizophrenia or bipolar disorder in short-term (≤12 weeks), placebo controlled trials as reported in manufacturer prescribing information.1–10 

Effect of atypical antipsychotics on lipid profile in patients with schizophrenia or bipolar disorder in short-term (≤12 weeks), placebo controlled trials as reported in manufacturer prescribing information.1–10
Effect of atypical antipsychotics on lipid profile in patients with schizophrenia or bipolar disorder in short-term (≤12 weeks), placebo controlled trials as reported in manufacturer prescribing information.1–10
Table 3.

Effect of atypical antipsychotics on lipid profile in patients with schizophrenia or bipolar disorder in long-term (≥24 weeks), placebo controlled trials as reported in manufacturer prescribing information.1–10 

Effect of atypical antipsychotics on lipid profile in patients with schizophrenia or bipolar disorder in long-term (≥24 weeks), placebo controlled trials as reported in manufacturer prescribing information.1–10
Effect of atypical antipsychotics on lipid profile in patients with schizophrenia or bipolar disorder in long-term (≥24 weeks), placebo controlled trials as reported in manufacturer prescribing information.1–10
Table 4.

Effect of atypical antipsychotics on blood glucose and rate of fasting blood glucose elevations in patients with schizophrenia or bipolar disorder in short and long-term placebo-controlled trials as reported in manufacturer prescribing information.1–10 

Effect of atypical antipsychotics on blood glucose and rate of fasting blood glucose elevations in patients with schizophrenia or bipolar disorder in short and long-term placebo-controlled trials as reported in manufacturer prescribing information.1–10
Effect of atypical antipsychotics on blood glucose and rate of fasting blood glucose elevations in patients with schizophrenia or bipolar disorder in short and long-term placebo-controlled trials as reported in manufacturer prescribing information.1–10
Table 5.

Summary of potential for metabolic adverse effects with atypical antipsychotics.1–13 

Summary of potential for metabolic adverse effects with atypical antipsychotics.1–13
Summary of potential for metabolic adverse effects with atypical antipsychotics.1–13
1.
Asenapine [package insert]
.
Whitehouse Station, NJ
:
Merck & Co, Inc
;
2011
.
2.
Aripiprazole [package insert]
.
Tokyo, Japan
:
Otsuka Pharmaceutical Co
;
2012
.
3.
Clozapine [package insert]
.
East Hanover, NJ
;
Novartis Pharmaceuticals Corp
;
2011
.
4.
Iloperidone [package insert]
.
East Hanover, NJ
;
Novartis Pharmaceuticals Corp
;
2013
.
5.
Lurasidone [package insert]
.
Marlborough, MA
;
Sunovion Pharmaceuticals Inc
;
2012
.
6.
Olanzapine [package insert]
.
Indianapolis, IN
;
Eli Lilly and Company
;
2011
.
7.
Paliperidone [package insert]
.
Titusville, NJ
;
Janssen Pharmaceuticals, Inc
;
2007
.
8.
Quetiapine [package insert]
.
Wilmington, DE
;
AstraZeneca Pharmaceuticals LP
;
2012
.
9.
Risperidone [package insert]
.
Titusville, NJ
;
Ortho-McNeil-Janssen Pharmaceuticals Inc
,
2007
.
10.
Ziprasidone [package insert]
.
Indianapolis, IN
;
Eli Lilly and Company
;
2011
.
11.
American Diabetes Association, American Psychiatric Association, American Association of Clinical Endocrinologists, North American Association for the Study of Obesity
.
Consensus development conference on antipsychotic drugs and obesity and diabetes
.
J Clin Psychiatry
.
2004
;
65
(
2
):
267
72
.
PubMed PMID: 15003083
.
12.
De Hert
M
,
Yu
W
,
Detraux
J
,
Sweers
K
,
van Winkel
R
,
Correll
CU.
Body weight and metabolic adverse effects of asenapine, iloperidone, lurasidone and paliperidone in the treatment of schizophrenia and bipolar disorder: a systematic review and exploratory meta-analysis
.
CNS Drugs
.
2012
;
26
(
9
):
733
59
. .
13.
Hasnain
M
,
Vieweg
WV
,
Hollett
B.
Weight gain and glucose dysregulation with second-generation antipsychotics and antidepressants: a review for primary care physicians
.
Postgrad Med
.
2012
;
124
(
4
):
154
67
. .