Pharmacodynamics of drug-induced weight gain

Body weight gain during treatment with drugs for any kind of disease may re present improvement of the disease itself. However, sometimes these drug-in duced alterations of the body's appetite-regulating mechanisms result in ex cessive weight gain, thus jeopardizing compliance with prescribed medicatio n. A number of drugs are capable of changing body weight as an adverse cons equence of their therapeutic effect. Included in this category are the psyc hotropic drugs such as antipsychotics, antidepressants and mood stabilizers . Antipsychotics are well-known culprits of weight gain. The low-potency (e .g., chlorpromazine and thioridazine) and atypical agents (e.g., clozapine, olanzapine, quetiapine and risperidone) are most often associated with wei ght gain. Antidepressants such as tricyclic antidepressants and monoamine o xidase (MAO) inhibitors are most often associated with significant weight g ain. The tertiary tricyclic antidepressant amitriptyline is thought to indu ce the most weight gain. Mood stabilizers such as lithium carbonate, valpro ic acid and carbamazepine also induce weight gain in a considerable number of patients. Treatment with corticosteroids is associated with dose-depende nt body weight gain in many patients and corticosteroid-induced obesity agg ravates other corticosteroid-associated health risks. Insulin therapy in di abetic patients usually increases body weight. Finally, sulfonylurea deriva tives, antineoplastic agents used for the treatment of breast cancer and se veral drugs used in migraine prophylaxis may cause body weight gain as well . (C) 2001 Prous Science. All rights reserved.