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 .
Olanzapine versus clozapine in treatment-resistant or treatment-intolerant schizophrenia
Clozapine has been the gold st and ard for treatment of patients with refractory schizophrenia but is associated with serious safety liabilities . This has prompted the search for therapeutic alternatives for treatment-resistant schizophrenia . The objective of this study was to compare the efficacy and safety of olanzapine versus clozapine in schizophrenic patients who failed to respond adequately to antipsychotic medication or who experienced intolerable adverse effects associated with the medication . This 18-week , r and omized , double-blind , parallel study compared treatment with either olanzapine ( 5 - 25 mg/day , n=75 ) or clozapine ( 100 - 500 mg/day , n=72 ) in patients with schizophrenia who were nonresponsive to , or intolerant of , st and ard acceptable antipsychotic therapy . At the 18-week endpoint , no statistically significant differences were found between olanzapine and clozapine in any efficacy measure used : Positive and Negative Syndrome Scale ( PANSS ) total , positive , negative , or general psychopathology or Clinical Global Impression severity ( CGI-S ) . Response rates based on the criteria of Kane et al. [ Arch . Gen. Psychiatry 45 ( 1988 ) 789 ] were also not significantly different between olanzapine-treated ( 57.9 % ) and clozapine-treated patients ( 60.8 % ) . There were no significant differences in measurements of extrapyramidal symptoms or electrocardiography , and no clinical ly and statistically significant changes were seen in vital signs or laboratory measures in either group . Both treatments were well tolerated . Olanzapine demonstrated similar efficacy to clozapine in patients who had failed previous treatment because of lack of efficacy ( treatment resistance ) or intolerable side effects ( treatment intolerance ) . Olanzapine therefore presents a safe alternative in the treatment of refractory schizophrenia
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 .