Switching antipsychotic agents can trigger both clinically relevant weight gain and weight loss. However, weight gain is more prominent.

The goal of a meta-analysis was to determine the link between antipsychotic use and clinically relevant weight change by investigating the percentage of subjects who had clinically relevant weight gain (CRWG, ≥7% weight gain) and clinically relevant weight loss (CRWL, ≥7% weight loss).

For searching randomized controlled trials of antipsychotics reporting CRWG and CRWL with participants 15 years or older in age, databases like PsycInfo, Embase, and PubMed were explored. Utilizing a random-effects model, a meta-analysis stratified by antipsychotic and study duration was carried out. In order to evaluate mental illness and antipsychotic naive status as modifiers for CRWG, meta-regression analyses were conducted.

Overall, 202 articles were incorporated. Antipsychotics that were incorporated were almost all linked to CRWG. For CRWL, the amount of data was insufficient to make definite judgements. Others who were antipsychotic-naive exhibited greater CRWG for some antipsychotics than people who switched to another antipsychotic. In addition, prolonged antipsychotic usage was connected to greater CRWG but not CRWL. People with schizophrenia had greater CRWG for some antipsychotics. However, this was inconsistent.

Weight gain and weight loss are both linked to switching antipsychotic medications. However, in antipsychotic-switch studies, CRWG was greater than CRWL. Antipsychotic-naive individuals' CRWG was more evident, showing their susceptibility to weight gain. The effect of diagnosis on CRWG is yet unclear.