Effects of antipsychotic medications on appetite, weight, and insulin resistance

Endocrinol Metab Clin North Am. 2013 Sep;42(3):545-63. doi: 10.1016/j.ecl.2013.05.006.


Although clozapine, olanzapine, and other atypical antipsychotic drugs (APDs) have fewer extrapyramidal side effects, they have serious metabolic side effects such as substantial weight gain, intra-abdominal obesity, and type 2 diabetes mellitus. Given that most patients with mental disorders face chronic, even life-long, treatment with APDs, the risks of weight gain/obesity and other metabolic symptoms are major considerations for APD maintenance treatment. This review focuses on the effects of APDs on weight gain, appetite, insulin resistance, and glucose dysregulation, and the relevant underlying mechanisms that may be help to prevent and treat metabolic side effects caused by APD therapy.

Keywords: Antipsychotic; Appetite; Glucose dysregulation; Insulin resistance; Obesity; Weight gain.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / pharmacology*
  • Antipsychotic Agents / therapeutic use
  • Appetite / drug effects*
  • Appetite / physiology
  • Diabetes Mellitus, Type 2 / chemically induced
  • Humans
  • Insulin Resistance / physiology*
  • Mental Disorders / drug therapy*
  • Weight Gain / drug effects*


  • Antipsychotic Agents