Antipsychotic drugs and obesity

Trends Mol Med. 2011 Feb;17(2):97-107. doi: 10.1016/j.molmed.2010.10.010. Epub 2010 Dec 22.


Mechanisms underlying antipsychotic cardiometabolic adverse effects are incompletely understood. This hampers the identification of high-risk patients, low-risk antipsychotics and preventive/ameliorative treatments. Recent clinical, molecular and genetic data suggest that: (i) antipsychotic-naïve samples provide the greatest power for mechanistic studies; (ii) weight and metabolic effects can be discordant, pointing to overlapping and distinct mechanisms; (iii) antipsychotics affect satiety and energy homeostasis signaling; (iv) the specific peptides mediating these effects are unknown but probably overlap with those involved in idiopathic obesity; and (v) single nucleotide polymorphisms in genes encoding known neurotransmitter receptors and metabolic proteins are promising pharmacogenomic targets for countering adverse affects. However, sophisticated molecular studies and genome-wide association studies, ideally in antipsychotic-naïve/first episode samples, are needed to further advance the field.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / metabolism
  • Humans
  • Obesity / chemically induced*
  • Obesity / genetics
  • Obesity / metabolism
  • Polymorphism, Genetic
  • Receptors, Neurotransmitter / genetics
  • Receptors, Neurotransmitter / metabolism


  • Antipsychotic Agents
  • Receptors, Neurotransmitter