Which antipsychotics carry the greatest risk of glucose intolerance?

Which antipsychotics carry the greatest risk of glucose intolerance?

• A. Clozapine and Olanzapine
• B. Quetiapine and Risperidone
• C. Ziprasidone and Aripiprazole
• D. Haloperidol and Lurasidone

Answer: (A)

Metabolic side effects, including glucose intolerance, are most pronounced with certain atypical antipsychotics. Clozapine and olanzapine are associated with the largest increases in weight, insulin resistance, and impaired glucose tolerance, which together raise the risk of developing diabetes. Their receptor effects, notably strong antihistaminic and 5-HT2C antagonism, drive appetite and weight gain, contributing to metabolic dysfunction. Other antipsychotics tend to have lower metabolic risk. Quetiapine and risperidone carry a moderate risk, while ziprasidone and aripiprazole are associated with relatively lower metabolic effects. Haloperidol, a typical antipsychotic, has less impact on glucose metabolism but higher risk of movement-related side effects, and lurasidone generally shows a favorable metabolic profile.

Metabolic side effects, including glucose intolerance, are most pronounced with certain atypical antipsychotics. Clozapine and olanzapine are associated with the largest increases in weight, insulin resistance, and impaired glucose tolerance, which together raise the risk of developing diabetes. Their receptor effects, notably strong antihistaminic and 5-HT2C antagonism, drive appetite and weight gain, contributing to metabolic dysfunction.

Other antipsychotics tend to have lower metabolic risk. Quetiapine and risperidone carry a moderate risk, while ziprasidone and aripiprazole are associated with relatively lower metabolic effects. Haloperidol, a typical antipsychotic, has less impact on glucose metabolism but higher risk of movement-related side effects, and lurasidone generally shows a favorable metabolic profile.