Weight gain and metabolic side effects with antipsychotic drugs in children

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Weight gain and metabolic side effects are some of the most troublesome side effects of atypical antipsychotics, especially when used in children and adolescents. There have been few studies on these side effects in children in Arab countries.


To determine weight gain and metabolic side effects in a group of children and adolescents on antipsychotic drugs (APDs) and to compare different group of atypical antipsychotics and typical APDs in terms of these side effects.


Sixty-four patients younger than 18 years of age with different psychiatric diagnoses and different types of APDs were assessed in terms of weight, height, BMI at the start of the study, and then after 3 and 6 months. Estimation of the BMI z-score and metabolic profile including fasting blood glucose, fasting lipid profile, and liver transaminases was carried out.


Significant weight gain and increase in BMI were found after 6 months (mean 3.5±3 and 1.7±1.2, respectively). In addition, 50% of our patients were either overweight or obese and 4.7% fulfilled the criteria of metabolic syndrome and 46.9% had one to two symptoms of metabolic syndrome. Weight gain was more common at a younger age and metabolic side effects were associated significantly with obesity. Although olanzapine led to the greatest weight gain 6.1±5.6 kg, there were no significant differences in weight gain and metabolic side effects between different drugs.


All groups of APD showed significant weight gain and increase in BMI; in addition, obesity was associated significantly with metabolic side effects. Therefore, prescription of APD to children should be revised and done only by professional child psychiatrists, with careful monitoring of weight and metabolic profile.

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