Risk factors and pattern of weight gain in youths using antipsychotic drugs

Casper C.L. van der Esch, Sanne M. Kloosterboer*, Jan van der Ende, Catrien G. Reichart, Mirjam E.J. Kouijzer, Matthias M.J. de Kroon, Emma van Daalen, Wietske A. Ester, Rob Rieken, Gwen C. Dieleman, Manon H.J. Hillegers, Teun van Gelder, Birgit C.P. Koch, Bram Dierckx

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

9 Citations (Scopus)


Antipsychotic-induced weight gain is a major health concern in children and adolescents. The aim of this study was to identify risk factors for weight gain during short-, middle- and long-term treatment with antipsychotic drugs in this young population. We analysed a combined prospective and a retrospective observational cohort of Dutch children and adolescents, starting with risperidone, aripiprazole or pipamperone treatment. Linear mixed models were used to test whether sex, age, baseline body-mass-index (BMI) z score, type of antipsychotic, dose equivalent/kg, duration of use, previous antipsychotic use, ethnicity, physical exercise, IQ, concomitant medication, and psychiatric classification predicted the BMI z score for a follow-up of < 15 weeks, 15–52 weeks or > 52 weeks. A total of 144 patients were included with a median [interquartile range ([IQR)] age of 9 (4) years and median follow-up of 30 (73) weeks. During the complete follow-up, the median (IQR) weight gain was 0.37 (0.95) BMI z score points. Antipsychotic-induced weight gain was found to be most pronounced during the first 15 weeks of use (BMI z score increase per week β = 0.02, 95% CI 0.01–0.03, p = 0.002). A higher baseline BMI z score and the absence of stimulant use were associated with a higher BMI z score during the entire follow-up and after 15 weeks, respectively. Previous treatment with an antipsychotic drug was associated with less weight gain during the first 15 weeks of treatment. Our findings underscore the importance of close patient monitoring during the first weeks of antipsychotic treatment with a focus on patients with a high baseline BMI z score.

Original languageEnglish
Pages (from-to)1263-1271
Number of pages9
JournalEuropean Child and Adolescent Psychiatry
Issue number8
Publication statusPublished - 24 Aug 2021

Bibliographical note

Funding Information:
SMK, BD and BCK received grant research support from The Netherlands Organization for Health Research and Development (ZonMW), Number 836041011.

Publisher Copyright:
© 2020, The Author(s).


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