University College London study identifies critical 90-day window for antipsychotic metabolic risks

A study published in The Lancet Psychiatry indicates that the first 90 days of second-generation antipsychotic treatment are a critical window for monitoring metabolic risks, specifically weight gain and blood sugar fluctuations. Researchers from University College London analyzed health records of nearly 97,000 adults in England aged 18 to 59 who were treated for severe mental illnesses, such as schizophrenia and bipolar disorder, between 2000 and 2023.

The findings revealed that during this initial three-month period, HbA1c levels (a measure of average blood sugar) rose approximately 14 times faster, and weight increased approximately nine times faster, compared to the period before treatment began. The study specifically examined medications including olanzapine, quetiapine, risperidone, and aripiprazole, noting that olanzapine had the most significant impact on diabetes risk factors.

Lead researcher Juan Carlos Bazo-Alvarez suggests that healthcare professionals should monitor both weight and blood sugar levels before initiating therapy and again during these first few months. The research highlights that monitoring weight alone may be insufficient, as changes in blood sugar and weight do not always occur simultaneously.