Strategies to control antipsychotic-induced weight gain

Abstract

To the editor: the recent article by Han et al. about the short and long term effects of antipsychotic drug treatment on weight gain and H1 receptor expression was highly interesting (Han et al., 2008). Interestingly, a number of new pharmacological as well as behavioral strategies for managing antipsychotic-induced weight gain have emerged over the past few years. For instance, Levy et al. in a recent study have shown that topiramate can be effectively used for controlling weight gain in schizophrenic patients on chronic anti psychotic therapy (Levy et al., 2007). Bupropion is another medication that is effective in reducing antipsychotic-induced weight gain. For instance, the average weight loss after the addition of bupropion is about 3.4 kg (Gadde et al., 2006). Similarly, replacement therapy with melatonin reduces weight gain secondary to the use of anti psychotics such as olanzapine (Raskind et al., 2007). The effectiveness of metformin in the management of antipsychotic-induced weight gain has been re confirmed in recent studies conducted by Wu et al. (Wu et al., 2008). Other drugs that have also been shown to be effective include acetazolamide andmemantine. In addition, the simultaneous use of behavioral therapies may make the pharmacological weight control strategies more effective. For instance, Khazaal et al. have recently demonstrated the effectiveness of cognitive behavioral therapy in controlling weight gain in patients on chronic anti psychotic therapy (Khazaal et al., 2007). Clearly, antipsychotic-induced weight gain is a major problem in patients on psycho-pharmacological agents. Hopefully, increased awareness amongst clinicians and