Attenuation of antipsychotic-induced weight gain with early behavioral intervention in drug-naive first-episode psychosis patients: A randomized controlled trial. WEIGHT GAIN AND ANTIPSYCHOTICS. DATA FROM EUFEST STUDY. Managing atypical antipsychotic-associated weight gain: 12-month data on a multimodal weight control program. Prevention of antipsychotic-induced weight gain with early behavioural intervention in first-episode psychosis: 2-year results of a randomized controlled trial Weight change from 3-year observational data: findings from the worldwide schizophrenia outpatient health outcomes database. The effects of an educational intervention on antipsychotic-induced weight gain. Weight gain as a prognostic indicator of therapeutic improvement during acute treatment of schizophrenia with placebo or active antipsychotic Interventions to reduce weight gain in schizophrenia. Evaluating an individualized lifestyle and life skills intervention to prevent antipsychotic-induced weight gain in first-episode psychosis. A randomized controlled trial undertaken to test a nurse-led weight management and exercise intervention designed for people with serious mental illness who take second generation antipsychotics Impact of Switching or Initiating Antipsychotic Treatment on Body Weight During a 6-Month Follow-Up in a Cohort of Patients With Schizophrenia Cognitive behavioural therapy for weight gain associated with antipsychotic drugs Weight gain during long-term treatment of obsessive-compulsive disorder: a prospective comparison between serotonin reuptake inhibitors. DRD2 promoter region variation predicts antipsychotic-induced weight gain in first episode schizophrenia. Weight gain associated with the −759C/T polymorphism of the 5HT2C receptor and olanzapine An exploratory randomized controlled study of a healthy living intervention in early intervention services for psychosis: the INTERvention to encourage ACTivity, improve diet, and reduce weight gain (INTERACT) study. Factors influencing acute weight change in patients with schizophrenia treated with olanzapine, haloperidol, or risperidone.
BACKGROUND The purpose of this study was to compare an early behavioral intervention ( EBI ) with nonstructured st and ard physical care ( routine care intervention [ RCI ] ) in preventing antipsychotic-induced weight gain in drug-naive first-episode psychosis patients . METHOD Sixty-one patients with a DSM-IV-diagnosed psychotic disorder were first r and omly assigned to 3 different antipsychotic treatments ( risperidone [ N = 23 ] , olanzapine [ N = 18 ] , and haloperidol [ N = 21 ] ) and subsequently r and omly assigned to the intervention condition ( EBI , N = 35 ) or RCI ( N = 27 ) . EBI was specifically design ed to teach strategies to enhance control over factors associated with antipsychotic-induced weight gain and consisted of 8 flexible intervention modules that incorporated behavioral interventions , nutrition , and exercise . In the RCI group , patients were informed about potential weight gain and advised to increase their exercise and limit food intake . Body weight and body mass index were measured at baseline and then weekly for 3 months . In addition to change in weight and body mass index , a third outcome measure was the proportion of patients who had gained more than 7 % of their body weight at 3 months . Participating patients were referred between August 2002 and September 2004 . RESULTS All 61 participants completed the study . Patients in the EBI group gained significantly less weight ( mean = 4.1 kg , SD = 4.0 ) than those allocated to the RCI group ( mean = 6.9 kg , SD = 4.5 ) ( p < .01 ) during the 3-month follow-up period . Similar findings were obtained when both groups were compared on treatment-induced change in body mass index , which was significantly less in the EBI group than in the RCI group ( 1.40 vs. 2.39 kg/m2 ) ( p < .01 ) . Accordingly , significantly fewer patients in the EBI group ( N = 11 ; 39.3 % ) than in the RCI group ( N = 26 ; 78.8 % ) ( p < .002 ) increased their baseline weight by more than 7 % , the cutoff for clinical ly meaningful weight gain . CONCLUSIONS EBI was effective in attenuating antipsychotic-induced weight gain in a drug-naive first-episode psychosis cohort . Patients displayed good adherence to this type of preventive intervention Context Schizophrenia is a chronic disease most frequently necessitating lifelong antipsychotic treatment . Selecting which antipsychotic is to be prescribed in an individual schizophrenia patient represents an important clinical decision that need to take into account efficacy and side effects . Objective Evaluating weight gain related with one year antipsychotic treatment in antipsychotic naive first-episode schizophrenia patients . Design This study is an analysis of weight gain associated with typical or atypical antipsychotics used in European First Episode Schizophrenia Trial ( EUFEST ) study . Subjects and Methods 113 first episode naïve antipsychotic schizophrenia patients included in EUFEST - Romanian cohort , who were r and omized to one of the 5 treatment arms .  Weight was obtained at baseline , 3 , 6 , 9 and 12 months for the 5 antipsychotics ( typical-Haloperidol ; atypical-Olanzapine , Amisulpride , Ziprasidone , Quetiapine ) . Results There are no statistically significant differences between groups treated with typical or atypical antipsychotics or between any individual antipsychotics concerning weight gain during the study . Weight gain was the highest in the first 3 months ( 57.49 % ) for all the studied neuroleptics . At the end of the study , the less increase was observed with ziprasidone ( 3.87 kg ) and the highest with olanzapine ( 9.83 kg ) . Conclusion Increase in weight has taken place for each individual neuroleptic , but also as a group ( all neuroleptics ) in the first three months ( 57.49 % ) . Therefore , we should address the issue of weight gain with great care , especially in first period of antipsychotic administration , in order to fast deploy intervention tailored to maintain pre-treatment weight BACKGROUND The purpose of this study was to test prospect ively the feasibility and efficacy of a multimodal weight control program for over-weight and obese severely mentally ill adults who had gained weight while taking atypical antipsychotic medications . METHOD Thirty-one subjects with schizophrenia or schizoaffective disorder ( DSM-IV ) , on treatment with atypical antipsychotics , participated in a 52-week , multimodal weight control program that incorporated nutrition , exercise , and behavioral interventions . The primary outcomes were measures of body mass index ( BMI ) and weight . A variety of secondary outcomes , including hemoglobin A(1c ) level , systolic and diastolic blood pressure , and cholesterol level , were compared from baseline to endpoint . Weight and BMI changes in the intervention group were also compared with changes in 20 nonintervention patients ( " usual care " group ) who were contemporaneously treated in the same clinics . RESULTS Twenty of the 31 subjects in the intervention group completed the program . Statistically significant pre-post improvements in weight ( p < .02 ) , BMI ( p < .02 ) , hemoglobin A(1c ) levels ( p < .001 ) , diastolic ( p < .001 ) and systolic ( p < .05 ) blood pressure , exercise level ( p < .003 ) , nutrition knowledge ( p < .0001 ) , and stage of change ( exercise [ p < .0001 ] and weight [ p < .008 ] ) were seen in the intervention group . Patients attended a mean of 69 % of the sessions during the year of the program . Weight and BMI also decreased significantly ( p = .01 ) in the intervention group compared with the " usual care " group , who gained weight during the observation period . CONCLUSIONS Individuals with schizophrenia and schizoaffective disorder were willing to attend , and benefited from , a weight control program that focused on nutrition , exercise , and motivation . The program result ed in clinical ly significant reductions in weight , BMI , and other risk factors for long-term poor health , including hemoglobin A(1c ) . In contrast , patients who did not receive the weight control intervention continued to gain weight While weight-management interventions are effective in attenuating antipsychotic-induced weight , there is no available evidence on their long-term effectiveness . This study sought to investigate the 2-year effects of an early behavioural intervention ( EBI ) design ed to prevent antipsychotic-induced weight gain in first-episode psychosis ( FEP ) patients . Sixty-one FEP patients were r and omized to receive either EBI or treatment-as-usual .  Intention-to-treat and observed-cases analysis showed that patients in the EBI group gained significantly less weight than those allocated to routine care at intervention completion ( 3-month follow-up ) with treatment effects maintained over 3months . Differences between groups were no longer significant by 12months . Weight-management interventions may need to be offered for longer periods to maintain preventative effects . Alternatively , booster sessions may need to be regularly delivered after intervention completion BACKGROUND Weight change data from r and omized clinical trials are often of limited duration and trials do not always report a full range of clinical ly relevant categorical end points . METHOD We conducted a post hoc analysis of data from the observational Worldwide Schizophrenia Outpatient Health Outcomes data base ( 2000 - 2005 ) on weight change in 4,626 patients completing 3 years of antipsychotic monotherapy with amisulpride , clozapine , olanzapine , quetiapine , risperidone , and oral and depot first-generation antipsychotics ( FGAs ) .  Reported outcomes included mean and categorical weight changes and the trajectories of different measures of weight change . RESULTS Mean weight gain was lowest with amisulpride ( 1.8 kg ; 95 % CI , 0.2 - 3.3 ) and highest with olanzapine ( 4.2 kg ; 95 % CI , 3.9 - 4.5 ) . Weight change for all antipsychotics was most rapid during the first 6 months ; subsequent weight change was slower but did not plateau . All drugs showed considerable individual variation in weight change . The proportion losing ≥7 % of their baseline bodyweight was highest with quetiapine ( 10 % ; 95 % CI , 7%-16 % ) and lowest with depot FGAs ( 5 % ; 95 % CI , 3%-10 % ) . Between 7 % and 15 % of patients moved into an overweight or obese body mass index (kg/m2)category ( ≥25 ) . CONCLUSIONS The degree of weight gain varied between antipsychotics . All antipsychotics were associated with significant ( ≥7 % ) weight loss and gain from baseline . The mean rate of weight gain was maximal during the first 6 months but continued over 3 years without a plateau in this specific cohort . Patients should receive regular monitoring of weight throughout treatment PURPOSE To assess the effect of an educational intervention on antipsychotic-induced weight gain among patients with schizophrenia . DESIGN AND METHODS Quasi-experimental . Seventy patients with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder entered this 6-month study condicted in the United States . All participants began receiving olanzapine treatment when they entered the study . The patients were then r and omly assigned to an intervention group or a st and ard care group . Over the next 4-months , the intervention group participated in weekly psychoeducation classes focused on nutrition , exercise , and living a healthy lifestyle . Patients were followed for an additional 2 months to assess weight change . FINDINGS A statistically significant difference in weight change between the two groups was observed post-treatment and at endpoint . At endpoint , the mean weight change of the intervention group was -.06 pounds , while the mean weight change in the st and ard care group was 9.57 pounds . In both groups , men gained significantly more weight than did women . CONCLUSIONS The results indicate that a structured educational intervention might have a positive effect on antipsychotic-induced weight gain among patients with schizophrenia Treatment-emergent weight gain may be a general marker of therapeutic improvement , even when improvements occur in the absence of active antipsychotic treatment . To investigate the association between treatment-emergent weight gain and therapeutic improvement across placebo and active treatments , and to examine the association between reported treatment-emergent weight changes and the treatments ’ reported efficacy . Data from a r and omized , double-blind trial comparing treatment of schizophrenia with placebo and olanzapine were used to correlate weight change and change in psychopathology . Additionally , we correlated effect sizes of the efficacy of clozapine , olanzapine , risperidone , haloperidol and placebo ( reported in meta-analytical review s ) , with their reported weight changes . Weight gain significantly correlated with clinical improvements for placebo and olanzapine . The correlation between treatments ’ efficacy and corresponding weight changes was high ( r 0.88 , p 0.05 ) . Treatment-emergent weight gain appears to be an important marker of symptom reduction , and may not be exclusively attributable to pharmacological perturbations Background Weight gain is common for people with schizophrenia and this has serious implication s for health and well being . Objectives To determine the effects of both pharmacological ( excluding medication switching ) and non pharmacological strategies for reducing or preventing weight gain in people with schizophrenia . Search methods We search ed key data bases and the Cochrane Schizophrenia Group 's trials register ( April 2006 ) , reference sections within relevant papers , h and search ed key journals , and contacted the first author of each relevant study and other experts to collect further information . Selection criteria We included all clinical r and omised controlled trials comparing any pharmacological or non pharmacological intervention for weight gain  ( diet and exercise counselling ) with st and ard care or other treatments for people with schizophrenia or schizophrenia-like illnesses . Data collection and analysis We reliably selected , quality assessed and extracted data from studies . As weight is a continuous outcome measurement , weighted mean differences ( WMD ) of the change from baseline were calculated . The primary outcome measure was weight loss . Main results Twenty-three r and omised controlled trials met the inclusion criteria for this review . Five trials assessed a cognitive/behavioural intervention and eighteen assessed a pharmacological adjunct . In terms of prevention , two cognitive/behavioural trials showed significant treatment effect ( mean weight change ) at end of treatment ( n=104 , 2 RCTs , WMD -3.38 kg CI -4.2 to -2.0 ) . Pharmacological adjunct treatments were significant with a modest prevention of weight gain ( n=274 , 6 RCTs , WMD - 1.16 kg CI -1.9 to -0.4 ) . In terms of treatments for weight loss , we found significantly greater weight reduction in the cognitive behavioural intervention group ( n=129 , 3 RCTs , WMD -1.69 kg CI -2.8 to -0.6 ) compared with st and ard care . Authors ' conclusions Modest weight loss can be achieved with selective pharmacological and non pharmacological interventions . However , interpretation is limited by the small number of studies , small sample size , short study duration and by variability of the interventions themselves , their intensity and duration . Future studies adequately powered , with longer treatment duration and rigorous methodology will be needed in further evaluating the efficacy and safety of weight loss interventions for moderating weight gain . At this stage , there is insufficient evidence to support the general use of pharmacological interventions for weight management in people with schizophrenia AIM Initiating antipsychotic medication frequently induces rapid , clinical ly significant weight gain . We aim ed to evaluate the effectiveness of a lifestyle and life skills intervention , delivered within 4 weeks of antipsychotic medication initiation , in attenuating weight gain in youth aged 14 - 25 years with first-episode psychosis ( FEP ) . METHODS We undertook a prospect i ve , controlled study in two early psychosis community services . Intervention participants ( n = 16 ) received a 12-week individualized intervention delivered by specialist clinical staff ( nurse , dietician and exercise physiologist ) and youth peer wellness coaches , in addition to st and ard care . A comparison group was recruited from a similar service and received st and ard care  ( n = 12 ) . RESULTS The intervention group experienced significantly less weight gain at 12 weeks compared to st and ard care ( 1.8 kg , 95 % CI -0.4 to 2.8 vs. 7.8 kg , 4.8 - 10.7 , P < 0.001 ) . Thirteen per cent ( 2/16 ) of the intervention group experienced clinical ly significant weight gain ( greater than 7 % of baseline weight ) , while 75 % ( 9/12 ) of the st and ard care group experienced this level of weight gain . Similar positive effects of the intervention were observed for waist circumference . CONCLUSIONS A lifestyle and life skills intervention delivered as part of st and ard care attenuated antipsychotic-induced weight gain in young people with FEP . The intervention was acceptable to the young people referred to the service . Such interventions may prevent the seeding of future disease risk and in the long-term help reduce the life expectancy gap for people living with serious mental illness Aim To test the effect of a nurse-led intervention on weight gain in people with serious mental illness prescribed and taking second generation antipsychotic medication . Background Weight gain and obesity has reached epidemic proportions in the general population with the prevalence of Metabolic Syndrome reaching 20–25 % of the global population . People with serious mental illness are at even higher risk , particularly those taking second generation antipsychotic medication . Design An experimental r and omized controlled trial was undertaken . Method The control group received a 12-week healthy lifestyle booklet . In addition to the booklet , the intervention group received weekly nutrition and exercise education , exercise sessions , and nurse support .  Participants ( n = 101 ) were assessed at baseline and 12 weeks . Data were collected between March 2008–December 2010 . Seven outcome measures were used : body measurements included girth ( cm ) , weight ( kg ) , height ( cm ) , and body mass index ( kg/m2 ) ; question naires included the medication compliance question naire , the Drug Attitude Inventory , the Liverpool University Neuroleptic Side Effect Rating Scale , and the Medical Outcomes Study Short Form 36 . Differences in primary outcome measures between baseline and 12 weeks follow-up were compared between intervention and control groups using st and ard bi-variate statistical tests . The study was conducted between 2008–2010 . Results The analysis of outcome measures for the control group ( n = 50 ) and intervention group ( n = 51 ) was not statistically significant . There was a mean weight change of −0·74 kg at 12 weeks for the intervention group ( n = 51 ) , while the control group ( n = 50 ) had a mean weight change of −0·17 kg at 12 weeks . Conclusion The results were not statistically significant Objective Although weight gain is one of the most widely studied adverse effects of second-generation antipsychotics , only relatively few studies have specifically evaluated the long-term effect of switching antipsychotic medication on body weight . We aim ed to evaluate the impact of switching antipsychotics on body mass index ( BMI ) during a 6-month follow-up period in a large cohort of patients with schizophrenia . Method Data came from a 6-month prospect i ve naturalistic survey in 6007 patients with schizophrenia . Results We prospect ively studied the effect on BMI of initiating or switching antipsychotic medication after 6 months of treatment among 3801 patients with schizophrenia in a real-life setting . Patients who were being treated with clozapine or olanzapine at baseline were more likely to experience a decrease in BMI during the follow-up period than the patients who were being treated with a conventional antipsychotic ( odds ratio , 2.25 and 1.68 , respectively ) . Patients treated with aripiprazole and , to a lesser extent , those treated with risperidone were more likely to experience a decrease in BMI during follow-up than patients treated with conventional antipsychotics ( odds ratio , 2.96 and 2.06 , respectively ) . Conclusions Our findings suggest that switching antipsychotics could be an effective strategy for reducing or preventing weight gain BACKGROUND Overweight and obesity are common concerns in individuals with severe mental disorders . In particular , antipsychotic drugs ( AP ) frequently induce weight gain . This phenomenon lacks current management and no previous controlled studies seem to use cognitive therapy to modify eating and weight-related cognitions . Moreover , none of these studies considered binge eating or eating and weight-related cognitions as possible outcomes . AIM The main aim of this study is to assess the effectivity of cognitive and behavioural treatment ( CBT ) on eating and weight-related cognitions , binge eating symptomatology and weight loss in patients who reported weight gain during AP treatment . METHOD A r and omized controlled study ( 12-week CBT vs. Brief Nutritional Education ) was carried out on 61 patients treated with an antipsychotic drug who reported weight gain following treatment .  Binge eating symptomatology , eating and weight-related cognitions , as well as weight and body mass index were assessed before treatment , at 12 weeks and at 24 weeks . RESULTS The CBT group showed some improvement with respect to binge eating symptomatology and weight-related cognitions , whereas the control group did not . Weight loss occurred more progressively and was greater in the CBT group at 24 weeks . CONCLUSION The proposed CBT treatment is particularly interesting for patients suffering from weight gain associated with antipsychotic treatment BACKGROUND The effect of extended anti-depressant treatment on weight has been poorly investigated . Also unknown is whether different compounds have differential effects . The aim of the present study was to assess changes in weight in obsessive-compulsive disorder ( OCD ) patients treated for 2.5 years with  clomipramine or selective serotonin reuptake inhibitors . METHOD 138 DSM-IV OCD patients who responded to 6-month acute treatment at the Mood and Anxiety Disorders Unit , Department of Neuroscience , University of Turin , Italy , were followed-up for 2 years while receiving open-label clomipramine , citalopram , fluoxetine , fluvoxamine , paroxetine , or sertraline .  Patients were consecutively recruited and followed from May 1998 to March 2003 . The mean percentage change in weight was compared for each group , as was the proportion of patients who had a > or = 7 % weight increase from baseline . RESULTS At the end of the 2.5-year study period , patients had gained a mean of 2.5 % of their body weight with respect to baseline ( 1.58 kg ) ; 14.5 % of the total sample experienced a significant ( > or = 7 % ) weight increase . Within each but the fluoxetine treatment group , paired t tests showed a significant increase in weight from baseline to final visit . Analysis of variance showed a significant difference between treatment groups ( p = .009 ) , with clomipramine being associated with the highest weight increase and fluoxetine and sertraline with the lowest . A higher proportion of clomipramine-treated patients ( 34.8 % ) gained > or = 7 % in weight as compared with sertraline and fluoxetine , which accounted for the lowest percentage of patients with a significant weight gain ( 4.5 % and 8.7 % , respectively ) , although this difference was not statistically significant . CONCLUSION Risk of weight gain during extended serotonin reuptake inhibitor treatment for OCD differs depending on which compound is used . The differences among antiobsessive drugs may affect compliance with medication and health risks Many antipsychotic medications carry a substantial liability for weight gain , and one mechanism common to all antipsychotics is binding to the dopamine D2 receptor . We therefore examined the relationship between -141C Ins/Del ( rs1799732 ) , a functional promoter region polymorphism in DRD2 , and antipsychotic-induced weight gain in 58 first episode schizophrenia patients enrolled in a r and omized trial of risperidone versus olanzapine . Carriers of the deletion allele ( n=29 ) were compared with Ins/Ins homozygotes ( noncarriers , n=29 ) in a mixed model encompassing 10 weight measurements over 16 weeks . Deletion allele carriers showed significantly more weight gain after 6 weeks of treatment regardless of assigned medication . Although deletion carriers were prescribed higher doses of olanzapine ( but not risperidone ) , dose did not seem to account for the genotype effects on weight gain . Given earlier evidence that deletion carriers show reduced symptom response to medication , additional study of appropriate treatment options for these patients seems warranted Weight gain from atypical antipsychotic use has become a significant problem . Recent reports have liked the −759 polymorphism of the 5HT2C receptor and obesity as well as weight gain from chlorpromazine , risperidone , and clozapine BACKGROUND People with psychosis often experience weight gain , which places them at risk of cardiovascular disease , diabetes , and early death . OBJECTIVE To determine the uptake , adherence , and clinical effectiveness of a healthy living intervention design ed to reduce weight gain . METHOD An exploratory r and omized controlled trial , comparing the intervention with treatment as usual ( TAU ) in 2 early intervention services for psychosis in Engl and . DSM-IV classification was the diagnostic criteria used to assign the psychiatric diagnoses . The primary outcome was change in body mass index ( BMI ) from baseline to 12-month follow-up . The study was conducted between February 2009 and October 2012 . RESULTS 105 service users , with a BMI of ≥ 25 ( ≥ 24 in South Asians ) , were r and omized to intervention  ( n = 54 ) or  TAU  ( n = 51 ) after stratification by recent commencement of antipsychotic medication . Ninety-three service users ( 89 % ) were followed up at 12 months . Between-group difference in change in BMI was not significant ( effect size = 0.11 ) . The effect of the intervention was larger ( effect size = 0.54 , not significant ) in 15 intervention ( 28 % ) and 10 TAU ( 20 % ) participants who were taking olanzapine or clozapine at r and omization . CONCLUSIONS The healthy living intervention did not show a significant difference in BMI reduction compared to the TAU group . TRIAL REGISTRATION www.is rct n.org identifier : IS RCT N22581937 OBJECTIVE Clinical factors predicting weight change in patients with schizophrenia and related disorders during acute treatment with the antipsychotic drugs olanzapine , risperidone , and haloperidol  were sought through retrospective analyses . METHOD Six-week body-weight data from 2 trials , study 1 comparing olanzapine and haloperidol ( N = 1,369 ) and study 2 olanzapine and risperidone ( N = 268 ) , were analyzed . Effects of 8 clinical ly relevant covariates -- therapy , clinical outcome ( Brief Psychiatric Rating Scale ) , baseline body mass index ( B BMI ) , increased appetite , age , gender , race , and dose -- on weight were compared . RESULTS In study 1 , olanzapine ( vs. haloperidol ) therapy , better clinical outcome , lower B BMI , and nonwhite race significantly affected weight gain . Effects of increased appetite and male gender on weight gain were significant for olanzapine but not for haloperidol . In study 2 , better clinical outcome , lower B BMI , and younger age significantly affected weight gain . Increased appetite was more frequent during olanzapine treatment than during haloperidol , but not significantly different from risperidone . Significant differences in effect on weight change were found between olanzapine and haloperidol but not between olanzapine and risperidone . No evidence was found that lower antipsychotic drug doses were associated with lower weight gain . CONCLUSION This report identifies predictive factors of acute weight change in patients with schizophrenia . Similar factors across antipsychotic drugs in predicting greater weight gain included better clinical outcome , low B BMI , and nonwhite race . Factors differing between conventional ( haloperidol ) and atypical ( olanzapine ) agents included increased appetite and gender . Choice of atypical antipsychotic drug ( olanzapine vs. risperidone ) was of minor importance with regard to influence on acute weight gain
We were able to rank most of the psychotropics based on the available evidence and recommendations from subject matter experts .
There were few discrepancies between published evidence and the expert panel in ranking these drugs .
Conclusion Potential for weight gain is an important consideration in choice of any psychotropic .
This tool will help clinicians select psychotropics on a case-by-case basis in order to minimize the impact of weight gain when making both intra-class and interclass choices
Introduction Psychotropic medication use is associated with  weight gain .
While there are studies and review s comparing weight gain for psychotropics within some classes , clinicians frequently use drugs from different classes to treat psychiatric disorders .
Objective To undertake a systematic review of all classes of psychotropics to provide an all encompassing evidence -based tool that would allow clinicians to determine the risks of weight gain in making both intra-class and interclass choices of psychotropics .