Department of Clinical Sciences, Division of Psychiatry, Umeå University, 90185 Umeå, Sweden.
Curr Psychiatry Rep. 2013 Mar;15(3):347. doi: 10.1007/s11920-012-0347-y.
Weight gain remains a well recognized yet difficult to treat adverse effect of many anti-psychotic drugs including agents of the first and second generation. The weight gain liabilities of antipsychotic drugs are partly associated with their ability to increase appetite. Most behavioral interventions for weight control remain of limited efficacy, possibly because they do not specifically target the neuroendocrine factors regulating appetite. Identifying new weight management interventions directly acting on the biochemical and neuroendocrine mechanisms of anti-psychotic induced weight gain may help to improve the efficacy of behavioral weight management programs. Such potentially specific strategies include (1) using diets which do not increase appetite despite calorie restriction; (2) countering thirst as an anticholinergic side-effect; (3) discouraging cannabis use and (4) adding metformin to a behavioral intervention. In view of our currently rather limited treatment repertoire it seems timely systematically to explore such novel options.
体重增加仍然是许多抗精神病药物（包括第一代和第二代药物）公认但难以治疗的不良反应。抗精神病药物的体重增加副作用部分与它们增加食欲的能力有关。大多数用于控制体重的行为干预措施仍然效果有限，可能是因为它们没有专门针对调节食欲的神经内分泌因素。确定新的体重管理干预措施，直接作用于抗精神病药物引起的体重增加的生化和神经内分泌机制，可能有助于提高行为体重管理计划的疗效。这些潜在的具体策略包括：（1）使用在限制热量的情况下不会增加食欲的饮食；（2）对抗抗胆碱能副作用引起的口渴；（3）劝阻使用大麻；（4）在行为干预中添加二甲双胍。鉴于我们目前的治疗方法非常有限，系统地探索这些新的选择似乎是及时的。
