Research
Hormonal
Topiramate is effective for reducing antipsychotic-induced weight gain but is limited by poor tolerability, specifically cognitive difficulties and paresthesia.
Topiramate can help reduce weight gain from antipsychotics, but it is not usually the first choice because it often causes side effects like tingling sensations (paresthesia) and trouble concentrating. It is typically reserved for patients who cannot take Metformin.
GoodQualifiesMEDIUM confidence
Meta-analyses showed that the addition of topiramate was also effective to reduce weight (-5.4 to -2.75 kg)... topiramate was less well-tolerated than placebo or metformin (OR = 24) and associated with a higher incidence of concentration difficulties (RR = 8.97) and paresthesia (RR = 2.03–2.67).
Why this rating
Supported by meta-analyses, but limited by high dropout rates due to side effects.
Source
Antipsychotic‐induced weight gain: Is the weight over? New guidelines needed
Nini de Boer et al. · Acta Psychiatrica Scandinavica · 2022
DOI 10.1111/acps.13485
narrative_reviewCited 6×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Metformin is an effective and well-tolerated adjunctive pharmacological intervention for treating and preventing antipsychotic-induced weight gain in patients with severe mental illness.Good
- Switching antipsychotics to Aripiprazole results in significant weight reduction, but adding Aripiprazole to an existing regimen is not recommended due to increased risks of agitation and akathisia.Good
- GLP-1 agonists (Liraglutide and Semaglutide) are promising interventions for reducing antipsychotic-induced weight gain, with Semaglutide showing superior efficacy to Liraglutide in general obesity populations, though evidence in SMI is still emerging.Moderate
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