We were able to rank most of the psychotropics based on the available evidence and recommendations from subject matter experts .
There were few discrepancies between published evidence and the expert panel in ranking these drugs .
Conclusion Potential for weight gain is an important consideration in choice of any psychotropic .
This tool will help clinicians select psychotropics on a case-by-case basis in order to minimize the impact of weight gain when making both intra-class and interclass choices
Introduction Psychotropic medication use is associated with  weight gain .
While there are studies and review s comparing weight gain for psychotropics within some classes , clinicians frequently use drugs from different classes to treat psychiatric disorders .
Objective To undertake a systematic review of all classes of psychotropics to provide an all encompassing evidence -based tool that would allow clinicians to determine the risks of weight gain in making both intra-class and interclass choices of psychotropics .
Is flunarizine a long-acting oral atypical antipsychotic? A randomized clinical trial versus haloperidol for the treatment of schizophrenia.
BACKGROUND Flunarizine is known as a nonspecific calcium channel blocker that has been used for decades for the treatment of migraine , vertigo , and cognitive deficits related to cerebrovascular disorders . Flunarizine also has dopamine D2 receptor blocking properties and was effective in animal models of predictive validity for antipsychotics . However , its clinical antipsychotic efficacy has never been investigated . OBJECTIVE To evaluate the therapeutic efficacy and tolerability of flunarizine compared to haloperidol in out patients with stable and chronic DSM-IV-defined schizophrenia and schizoaffective disorder . METHOD Seventy patients from 2 centers were r and omly assigned and participated in a double-blind , parallel-group , flexible-dose study comparing flunarizine ( 10 - 50 mg/day ) and haloperidol ( 2.5 - 12.5 mg/day ) for 12 weeks . Patients were assessed with the Positive and Negative Syndrome Scale ( PANSS ) , the Clinical Global Impressions-Improvement ( CGI-I ) scale , the Extrapyramidal Symptom Rating Scale ( ESRS ) , a battery for cognitive performance , and laboratory examinations . The study was conducted from September 2004 to May 2007 . RESULTS Mean doses at endpoint were 29.7 mg/day for flunarizine and 6.4 mg/day for haloperidol . Both groups showed significant symptom improvement during the study , with a reduction of 21 % in the flunarizine group and 19 % in the haloperidol group in PANSS total scores ( p < .05 ) . There were no significant differences in PANSS overall score and all subscales , CGI-I score , or cognitive performance . Dropout rates , ESRS scores , and prolactin levels were not different between groups , but significantly more patients reported emergence of akathisia in the haloperidol group ( p = .04 ) , and weight gain was significantly higher with flunarizine ( 1.2 kg ) than with haloperidol ( -0.8 kg ) ( p < .05 ) . CONCLUSION This is the first study evaluating the antipsychotic properties of flunarizine , which showed good efficacy and tolerability for the treatment of schizophrenia , with a possible atypical profile . Its unique pharmacokinetic profile as an oral drug with long half-life ( 2 - 7 weeks ) , low cost , and low induction of extrapyramidal symptoms warrants further investigation , particularly in psychiatric patients with low adherence to treatment
We were able to rank most of the psychotropics based on the available evidence and recommendations from subject matter experts .
There were few discrepancies between published evidence and the expert panel in ranking these drugs .
Conclusion Potential for weight gain is an important consideration in choice of any psychotropic .
This tool will help clinicians select psychotropics on a case-by-case basis in order to minimize the impact of weight gain when making both intra-class and interclass choices
Introduction Psychotropic medication use is associated with  weight gain .
While there are studies and review s comparing weight gain for psychotropics within some classes , clinicians frequently use drugs from different classes to treat psychiatric disorders .
Objective To undertake a systematic review of all classes of psychotropics to provide an all encompassing evidence -based tool that would allow clinicians to determine the risks of weight gain in making both intra-class and interclass choices of psychotropics .