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Weight gain associated with some, not all second-generation antipsychotics for ASD

Recent findings indicated significant weight gain associated with risperidone, aripiprazole and olanzapine but not ziprasidone or quetiapine among youth with autism spectrum disorders.

“Caregivers treating children and teens with ASD, and parents, can use this information to balance the risks and benefits of [second-generation antipsychotics] for treating irritability associated with autism spectrum disorders,” study researcher Logan Wink, MD, of Cincinnati Children’s Hospital Medical Center, said in a press release.

Logan Wink

To compare weight gain associated with second-generation antipsychotics for treatment of ASD, researchers analyzed demographic and treatment data for 202 youth with ASD treated at two large subspecialty psychiatry clinics. Study participants were aged 2 to 20 years and received one of the following second-generation antipsychotics: risperidone, aripiprazole, olanzapine, quetiapine or ziprasidone for up to 4 years.

Risperidone (P = .03), aripiprazole (P = .05), and olanzapine (P < .01) were associated with statistically significant increases in BMI z-scores.

Ziprasidone (P = .47) and quetiapine (P = .11) were not associated with increases in BMI z-scores.

Participants who received olanzapine exhibited statistically significant greater increases in BMI z-scores compared with all other second-generation antipsychotics (P < .05).

Adjusting for multiple testing or weight gain-attenuating medication did not alter these findings.

“Our results demonstrate that olanzapine was associated with the most significant weight gain among the five [second-generation antipsychotics] compared, and ziprasidone was not associated with statically significant weight gain in our population. Surprisingly, quetiapine was also not associated with significant weight gain in this patient group,” the researchers wrote. “Given the nature of this retrospective chart review study, the results of this study must be considered along with its limitations. However, we feel these data will help guide clinicians as they make difficult treatment decisions.” – by Amanda Oldt

Disclosure: Yoon reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosures.