From the FDA Drug Label
Weight gain has been observed with atypical antipsychotic use. Clinical monitoring of weight is recommended. In an analysis of 13 placebo-controlled monotherapy trials, primarily from pooled schizophrenia and another indication, with a median exposure of 21 to 25 days, the mean change in body weight in aripiprazole-treated patients was +0. 3 kg (N=1673) compared to –0.1 kg (N=1100) in placebo-controlled patients. Table 14 shows the percentage of adult patients with weight gain ≥7% of body weight by indication. Table 14: Percentage of Patients From Placebo-Controlled Trials in Adult Patients with Weight Gain ≥7% of Body Weight Indication Treatment Arm N Patients n (%) Weight gain≥ 7% of body weight Schizophrenia * Aripiprazole Tablets 852 69 (8.1) Placebo 379 12 (3. 2) other indication † Aripiprazole Tablets 719 16 (2.2) Placebo 598 16 (2. 7) In an analysis of two placebo-controlled trials in adolescents with schizophrenia (13 to 17 years) and pediatric patients with another indication (10 to 17 years) with median exposure of 42 to 43 days, the mean change in body weight in aripiprazole-treated patients was +1.6 kg (N=381) compared to +0. 3 kg (N=187) in placebo-treated patients. Table 15 shows the percentage of pediatric and adolescent patients with weight gain ≥7% of body weight by indication Table 15: Percentage of Patients From Placebo-Controlled Monotherapy Trials in Pediatric and Adolescent Patients with Weight Gain ≥7% of Body Weight Indication Treatment Arm N Patients n (%) Weight gain ≥7% of body weight Pooled Schizophrenia and another indication * Aripiprazole Tablets 381 20 (5.2) Placebo 187 3 (1. 6)
The percentage of patients to gain weight when they take aripiprazole is as follows:
- Schizophrenia: 8.1% of adult patients and 5.2% of pediatric and adolescent patients experienced weight gain ≥7% of body weight.
- Other indication: 2.2% of adult patients experienced weight gain ≥7% of body weight. It is also noted that after 26 weeks, 32.8% of pediatric and adolescent patients gained ≥7% of their body weight, not adjusted for normal growth 1.
From the Research
Approximately 5-10% of patients taking aripiprazole experience weight gain as a side effect, with the most recent and highest quality study suggesting a mean weight increase of 2.1 kg for brexpiprazole and 3.0 kg for aripiprazole in long-term schizophrenia studies 2. This antipsychotic medication, sold under brand names like Abilify, is generally considered to have a lower risk of weight gain compared to other antipsychotics such as olanzapine or quetiapine. The weight gain is typically modest, averaging around 2-3 pounds over the course of treatment, though individual responses vary significantly. The mechanism behind this side effect involves aripiprazole's action on dopamine and serotonin receptors, which can affect appetite regulation and metabolism. Some key points to consider include:
- Patients with a history of weight issues or metabolic disorders may be at higher risk.
- Regular monitoring of weight, particularly during the first few months of treatment, is recommended.
- Lifestyle modifications including regular exercise and a balanced diet can help mitigate this side effect.
- If significant weight gain occurs, discussing medication alternatives with your healthcare provider is advisable, but never discontinue aripiprazole suddenly without medical supervision. It's also worth noting that aripiprazole has been shown to have a similar effect on body weight as brexpiprazole in the treatment of schizophrenia and major depressive disorder 2. Additionally, combining aripiprazole with other medications, such as clozapine, may result in significant weight and metabolic benefits 3. However, the most recent and highest quality study should be prioritized when making treatment decisions, and in this case, the study by 2 provides the most up-to-date information on the effects of aripiprazole on body weight.