What three antipsychotics have very low weight gaining effects?

• A. Geodon, Abilify, and Latuda
• B. Zyprexa, Risperdal, Seroquel
• C. Haldol, Thorazine, Invega
• D. Clozaril, Risperdal, Geodon

Answer: (A)

Weight gain risk varies across antipsychotics, and choosing a medicine often hinges on metabolic side effects. The drugs with the lowest weight gain risk are Geodon (ziprasidone), Abilify (aripiprazole), and Latuda (lurasidone). These agents are commonly associated with weight being stable or only minimally affected, making them preferable when weight gain or metabolic syndrome is a major concern. Individual responses vary, but overall these three tend to have the most favorable weight profiles among the atypicals.

Context helps: ziprasidone is generally weight neutral but has a risk of QT prolongation and should be taken with food to optimize absorption. Aripiprazole is often weight neutral and can be activating in some patients, with a potential for akathisia. Lurasidone is typically weight neutral as well but also needs to be taken with food to improve absorption and can cause GI side effects or somnolence in some individuals. In contrast, olanzapine and clozapine carry a higher risk of significant weight gain and metabolic changes, while risperidone and quetiapine tend to have more weight gain than the three best options.