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Atypical antipsychotics and effects on feeding: from mice to men

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Abstract

Rationale

So-called atypical antipsychotics (AAPs) are associated with varying levels of weight gain and associated metabolic disturbances, which in patients with serious mental illness (SMI) have been linked to non-compliance and poor functional outcomes. Mechanisms underlying AAP-induced metabolic abnormalities are only partially understood. Antipsychotic-induced weight gain may occur as a result of increases in food intake and/or changes in feeding.

Objective

In this review, we examine the available human and preclinical literature addressing AAP-related changes in feeding behavior, to determine whether changes in appetite and perturbations in regulation of food intake could be contributing factors to antipsychotic-induced weight gain.

Results

In general, human studies point to disruption by AAPs of feeding behaviors and food consumption. In rodents, increases in cumulative food intake are mainly observed in females; however, changes in feeding microstructure or motivational aspects of food intake appear to occur independent of sex.

Conclusions

The findings from this review indicate that the varying levels of AAP-related weight gain reflect changes in both appetite and feeding behaviors, which differ by type of AAP. However, inconsistencies exist among the studies (both human and rodent) that may reflect considerable differences in study design and methodology. Future studies examining underlying mechanisms of antipsychotic-induced weight gain are recommended in order to develop strategies addressing the serious metabolic side effect of AAPs.

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Abbreviations

AAP:

Atypical antipsychotic

ARI:

Aripiprazole

CLO:

Clozapine

EPSE:

Extrapyramidal side effects

HAL:

Haloperidol

OLA:

Olanzapine

QUE:

Quetiapine

REE:

Resting energy expenditure

RIS:

Risperidone

VAS:

Visual analog scale

WAT:

White adipose tissue mass

ZIP:

Ziprasidone

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Authors and Affiliations

  1. Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada

    Louise Benarroch, Chantel Kowalchuk, Virginia Wilson, Celine Teo, Melanie Guenette, Araba Chintoh, Yasika Nesarajah, Valerie Taylor, Peter Selby, Paul Fletcher, Gary J. Remington & Margaret K. Hahn

  2. Institute of Medical Sciences, University of Toronto, 1 King’s College Circle, Toronto, ON, M5S 1A8, Canada

    Chantel Kowalchuk, Gary J. Remington & Margaret K. Hahn

  3. Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON, M5T 1R8, Canada

    Araba Chintoh, Valerie Taylor, Gary J. Remington & Margaret K. Hahn

  4. Women’s College Research Institute, 7th Floor, 790 Bay St, Toronto, ON, M5G 1N8, Canada

    Valerie Taylor

  5. Department of Family and Community Medicine, University of Toronto, 500 University Ave, Toronto, ON, M5G 1V7, Canada

    Peter Selby

  6. Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada

    Peter Selby

  7. Department of Psychology, University of Toronto, 100 St. George Street, Toronto, ON, M5S 3G3, Canada

    Paul Fletcher

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  1. Louise Benarroch
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  2. Chantel Kowalchuk
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  3. Virginia Wilson
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  4. Celine Teo
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  8. Valerie Taylor
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  9. Peter Selby
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  10. Paul Fletcher
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  11. Gary J. Remington
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  12. Margaret K. Hahn
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Correspondence to Gary J. Remington or Margaret K. Hahn.

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Louise Benarroch and Chantel Kowalchuk shared co-first authorship.

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Benarroch, L., Kowalchuk, C., Wilson, V. et al. Atypical antipsychotics and effects on feeding: from mice to men. Psychopharmacology 233, 2629–2653 (2016). https://doi.org/10.1007/s00213-016-4324-8

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  • DOI: https://doi.org/10.1007/s00213-016-4324-8

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