Battle of the Antipsychotic Bulge: Switching and Weight Gain

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The Bottom Line

Antipsychotic switching, notably to aripiprazole or ziprasidone, may lead to weight loss, while switching to olanzapine or clozapine can worsen cardiometabolic status. However, clinicians should note that antipsychotic switching is only one strategy to mitigate adverse cardiometabolic effects of antipsychotics. Other options include adjunctive medications such as metformin or statins, as well as dietary and lifestyle interventions. Furthermore, the cardiometabolic profile of both the pre- and post-switch antipsychotic, as well as patient preferences and factors, must be considered in clinical decision-making.

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