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Medication side effects, as well as lifestyle and disease factors, place patients with schizophrenia at increased risk of developing obesity and metabolic side effects, including glucose intolerance, type 2 diabetes, diabetic ketoacidosis, and hyperlipidemia (Dixon et al. 2000; Meyer and Koro 2004; Wirshing et al. 2002, 2003). While clinically significant weight gain occurs in a substantial proportion of patients receiving an antipsychotic medication (Baptista 1999), a convincing body of evidence indicates that certain atypical antipsychotics cause more weight gain than other agents (Allison et al. 1999; Lieberman et al. 2005; Wirshing et al. 1999). A large meta-analytic study of atypical and typical antipsychotics (Wirshing et al. 1999) found a mean weight gain of 9.8 lbs with clozapine, 9.1 lbs with olanzapine, and 4.6 lbs with risperidone, compared with 2.4 lbs with haloperidol, while the atypical antipsychotic ziprasidone was associated with a less than 1-lb weight gain. Furthermore, the CATIE study demonstrated a greater than 7% weight gain from baseline in 30% of patients receiving olanzapine, 16% of those receiving quetiapine, 14% of those receiving risperidone, 12% of those receiving perphenazine, and 7% of those receiving ziprasidone (Lieberman et al. 2005).

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