Weight gain in newly diagnosed first-episode psychosis patients and healthy comparisons: One-year analysis

Martin Strassnig, Jean Miewald, Matcheri Keshavan, Rohan Ganguli

Research output: Contribution to journalArticlepeer-review

109 Scopus citations


Background: Various antipsychotics are associated with body weight gain. However, most study samples include high proportions of patients with chronic schizophrenia. We examined neuroleptic-induced weight gain in drug-naïve first-episode psychotic patients to limit confounding variables such as multiple past medication trials, history of partial adherence; or poor diet and a sedentary lifestyle, associated with chronic mental illness. Methods: Newly diagnosed first-episode psychosis patients treated with antipsychotic medication, a small group of patients not receiving antipsychotics, and healthy comparisons were followed for one year. Body weight differences and proportions of subjects with more than 7% weight gain were calculated. The effects of concomitant psychotropic medication on weight gain were explored. Results: Ninety-eight first-episode psychotics patient and 30 healthy controls were examined. Patients receiving neuroleptics gained significantly more weight than healthy controls (p = 0.002). Olanzapine (91% gained > 7%) increased body weight by 37.3 ± 27.7 lb, followed by risperidone (51%; + 16.6 ± 22) and haloperidol (47%; + 9 ± 12), and perphenazine (10%; + 3.4 ± 6). Younger patients (r = - 0.24, p = 0.02) and patients with more negative symptoms at baseline (SANS global; r = 0.22, p = 0.04) gained more weight. A greater number of co-medications per patient, and co-prescription of antidepressants significantly and independently increased antipsychotic-associated weight gain. Discussion: The results confirm substantial and clinically significant weight gain introduced by antipsychotic treatment in drug-naïve first-episode psychotic patients, and identify several treatment-associated risk factors for weight gain. The magnitude of weight gain induced highlights potential health risks and points to the need for preventive measures such as behavioral weight control programs along with the initiation of pharmacotherapy.

Original languageEnglish (US)
Pages (from-to)90-98
Number of pages9
JournalSchizophrenia Research
Issue number1-3
StatePublished - Jul 2007


  • Antidepressants
  • Antipsychotics
  • First-episode psychosis
  • Obesity
  • Predictors
  • Schizophrenia
  • Weight gain
  • Weight gain prevention

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Behavioral Neuroscience
  • Biological Psychiatry
  • Neurology
  • Psychology(all)


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