Relationship between antipsychotic medication, obesity and cognitive functions

Urszula Łopuszańska 1  and Marta Makara-Studzińska 2
  • 1 Department of Applied Psychology, Medical University of Lublin, Poland
  • 2 Department of Developmental and Health Psychology, Jagiellonian University - Collegium Medicum, Cracow


Introduction: The purpose of this study was to examine whether the combination of atypical and typical antipsychotic medications is related with metabolism and cognitive functions in the same manner and degree as taking medications of one kind only, i.e. atypical or typical.

Material and methods: The participants of the study comprised of 91 adults with diagnosed mental illness (F-20-F69). The participants were divided into groups on the basis of the kind of administered medications: T+A (typical and atypical medications), A (atypical medications), T (typical medications), P (antidepressants, sedatives, normothymic/antiepileptic drugs). In the study, Short Test of Mental Status (STMS), Verbal Fluency Test (VFT), Rey Auditory Verbal Learning Test (RAVLT) were used for the purpose of examining cognitive functions.

Results: The kind of antipsychotic medications taken by the patients did not differentiate the group in relation to BMI (p<0.13), nor in relation to the level of general cognitive function (p<0.72) or verbal fluency (p<0.34). Both atypical antipsychotic medications and the combination of atypical and typical medications were related to the occurrence of abdominal obesity (p<0.01). An increase in waist circumference decreased an ability of abstract reasoning (p<0.005). When it comes to the body mass index, waist circumference negatively correlated with the delayed memory (p< 0.03, p<0.004).

Discussion: Both the combination of atypical and typical antipsychotic medications and atypical medications are associated with the occurrence of abdominal obesity. The deposition of fat tissue in the abdomen negatively correlated with an ability to learn.

Conclusions: The future studies might explain the interactions between antipsychotic medications, obesity and cognitive function.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • 1. Department of Health, Government of South Australia 2006,, (accessed 31 December 2015)

  • 2. International Obesity Taskforce. IOTF: The Global Epidemic: IASO/IOTF analysis 2010. (accessed 31 December 2014)

  • 3. Wąsowski M, Walicka M, Marcinowska-Suchowierska E. Obesity – definition, epidemiology, pathogenesis, Post Nauk Med. 2013(4):301-306

  • 4. World Health Organization: The challenge of obesity in the WHO European Region. Fact sheet EURO 2005; 13: 1-4

  • 5. World Health Organization: Obesity and overweight, 2014,, (access 6 January 2015)

  • 6. Despre´s J-P. Abdominal obesity: the most prevalent cause of the metabolic syndrome and related cardiometabolic risk, European Heart Journal Supplements. 2006; 8 (Supplement B), B4–B12, doi:10.1093/eurheartj/sul002)

  • 7. National Heart, Lung, and Blood Institute’s Expert Panel on the Identification, Evaluation, and Treatment of Overweight in Adults. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: executive summary. Am. J. Clin. Nutr. 1998; 68: 899–917

  • 8. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III)., JAMA. 2001 16;285(19):2486-97

  • 9. Alberti G, Zimmet PZ, Shaw J, Grundy SM. International Diabetes Federation 2006: The IDF consensus worldwide definition of the metabolic syndrome., (access 6 January 2015)

  • 10. Cull CA, Jensen CC, Retnakaran R, Holman RR. Impact of the metabolic syndrome on macrovascular and microvascular out-comes in type 2 diabetes mellitus: United Kingdom Prospective Diabetes Study 78, Circulation. 2007; 6;116(19):2119-26

  • 11. McElroy SL, Guerdjikova A, Kotwal R. Severe mental illness and obesity. In: Bermudes RA, Keck PE, McElroy SL, editors. Managing metabolic abnormalities in the psychiatrically ill: a clinical guide for psychiatrists. Arlington: American Psychiatric Publishing; 2006: 55–119

  • 12. Newcomber JW, Antipsychotic medications: metabolic and cardiovascular risk, J Clin Psychiatry. 2007;68(4):8-13

  • 13. Rzewuska M. Metabolic risk during antipsychotic treatment in patients with schizophrenia, Zaburzenia metaboliczne związane ze stosowaniem LPP u chorych na schizofrenię, Psychiatr Pol 2007; 41 (4):457–472

  • 14. Ryan MC, Flanagan S, Kinsella U. The effects of atypical antipsy-chotics on visceral fat distribution in first episode, drug-naive patients with schizophrenia. Life Sci. 2004;74:1999–2008

  • 15. Duda-Sobczak A., Wierusz-Wysocka B. Diabetes mellitus and psychiatric diseases, Cukrzyca a choroby psychiczne. Psychiatr Pol 2011; 45(4): 589–598

  • 16. Elias MF, Elias PK, Sullivan LM, Wolf PA, D'Agostino RB. Lower cognitive function in the presence of obesity and hypertension: the Framingham heart study. Int J Obes Relat Metab Disord. 2003;27(2):260-268

  • 17. Goodyer IM, Park, R.J, Herbert J. Psychosocial and endocrine features of chronic first-episode major depression in 8-16 year olds. Biological Psychiatry. 2001; 5O(5):351-357

  • 18. Berkowitz RI1, Fabricatore AN. Obesity, psychiatric status, and psychiatric medications. Psychiatr Clin North Am. 2011; 34(4):747-64

  • 19. Wirshing DA. Schizophrenia and obesity: impact of antipsychotic medications. J Clin Psychiatry. 2004;65 (18):13-26

  • 20. Monteleone P1, Martiadis V, Maj M. Management of schizophrenia with obesity, metabolic, and endocrinological disorders. Psychiatr Clin North Am. 2009;32(4):775-94

  • 21. McElroy SL1, Kotwal R, Malhotra S, Nelson EB, Keck PE, Nemeroff CB. Are mood disorders and obesity related? A review for the mental health professional. J Clin Psychiatry. 2004; 65(5):634-51, quiz 730

  • 22. Mitchell AJ, Vancampfort D, Sweers K, van Winkel R, Yu W, and De Hert M. Prevalence of Metabolic Syndrome and Metabolic Abnormalities in Schizophreniaand Related Disorders—A Systematic Review and Meta-Analysis. Schizophrenia Bulletin 2011; 29: 1-13

  • 23. De Hert M, Correll ChU, Bobes J, Cetkovich-Bakmas M, Cohen D, et al. Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care, Wolrd Psychiatry 2011; 10(1):52-77

  • 24. Joseph A. Lieberman. Metabolic Changes Associated With Anti-psychotic Use, Prim Care Companion J Clin Psychiatry. 2004; 6(2): 8–13

  • 25. Sicras-Mainar A, Navarro-Artieda R, Rejas-Gutiérrez J, Blanca-Tamayo M. Relationship between obesity and antipsychotic drug use in the adult population: A longitudinal, retrospective claim database study in Primary Care settings, Neuropsychiatr Dis Treat. 2008; 4(1): 219–226

  • 26. Zhao G, Ford ES, Li Ch, Tsai J, Dhingra S, Balluz LS. Waist circumference, abdominal obesity, and depression among overweight and obese U.S. adults: national health and nutrition examination survey 2005-2006, BMC Psychiatry 2011,, (access 16 January 2015)

  • 27. Woodward ND, Purdon SE, Meltzer HY, Zald DH. A meta-analysis of neuropsychological change to clozapine, olanzapine, quetia-pine and risperidone in schizophrenia. Int J Neuropsychophar-macol 2005; 8:457–72

  • 28. Lis S, Krieger S, Gallhofer B, Torre P, Mittoux A, Menard F. Sertindole is superior to haloperidol in cognitive performance in patients with schizophrenia: A comparative study. Eur Neuropsy-chopharmacol 2003;13(4):323–324

  • 29. Minzenberg MJ, Poole JH, Benton C, Vinogradov S. Association of anticholinergic load with impairment of complex attention and memory in schizophrenia. Am. J. Psychiatry 2004; 161:116–124

  • 30. Capleton R Cognitive function in schizophrenia: association with negative and positive symptoms. Psychol Rep. 1996; 78: 123-128

  • 31. O’Leary D, Flaum M, Kesler M, Flashman L, Arndt S, Andreasen NC Cognitive correlates of the negative, positive, and psychotic symptom dimensions in schizophrenia. J Neuropsychiatry Clin Neurosci. 2000; 12: 4-15

  • 32. Gunstad J, Paulb RH, Cohenb RA, Tateb DF, Spitznagelc MB, Gordon E. Elevated body mass index is associated with executive dysfunction in otherwise healthy adults. Comprehensive Psy-chiatr., 2007; 48: 57-61

  • 33. Alosco ML1, Spitznagel MB, Gunstad J. Obesity as a risk factor for poor neurocognitive outcomes in older adults with heart failure. Heart Fail Rev. 2014; 19(3):403-11

  • 34. Stanek KM, Grieve SM, Brickman AM, Korgaonkar MS, Paul RH, Cohen RA, Gunstad JJ. Obesity is associated with reduced white matter integrity in otherwise healthy adults. Obesity. 2011; 19: 500-504

  • 35. Gustafson D, Steen B, Skoog I. Body mass index and white matter lesions in elderly women. An 18-year longitudinal study. Int Psychogeriat. 2004;16:327 – 36

  • 36. Rahmouni K, Correia ML, Haynes WG, Mark AL. Obesity-associated hypertension: new insights into mechanisms. Hyper-tension. 2005;45:9–14

  • 37. Gustafson D, Lissner L, Bengtsson C, Bjorkelund C, Skoog I. A 24-year follow-up of body mass index and cerebral atrophy. Neurology. 2004; 63:1876 – 81

  • 38. Gazdzinski S, Kornak J, Weiner MW, Meyerhoff DJ. Body mass index and magnetic resonance markers of brain integrity in adults. Ann Neurol. 2008;63(5):652-7

  • 39. Roy A, Jana M, Corbett GT, Ramaswamy S, Kordower JH, Gonzalez FJ, Pahan K., Regulation of CREB and hippocampal plasticity-related genes by peroxisome proliferator-activated receptor α, Cell Rep. 2013; 4(4): 724–737.

  • 40. Spitznagel MB, Garcia S, Miller LA, Strain G, Devlin M, Wing R, Cohen R, Paul R, Crosby R, Mitchell JE., Gunstad J, Cognitive Function Predicts Weight Loss Following Bariatric Surgery, Surg Obes Relat Dis. 2013; 9(3): 453–459

  • 41. Levy B., Manove E. Functional Outcome in Bipolar Disorder: The Big Picture, Depression Research and Treatment, 2012; (2012):1-12

  • 42. Trivedi JK. Cognitive deficits in psychiatric disorders: Current status, Indian J Psychiatry. 2006; 48(1): 10–20

  • 43. Gustafson DR, Bäckman K, Joas E, Waern M, Östling S, Guo X, Skoog I. 37 years of body mass index and dementia: observations from the prospective population study of women in Gothenburg, Sweden. J Alzheimers Dis. 2012;28(1):163-71


Journal + Issues