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 .
Efficacy and tolerability of olanzapine, quetiapine, and risperidone in the treatment of early psychosis: a randomized, double-blind 52-week comparison.
OBJECTIVE This 52-week r and omized , double-blind , flexible-dose , multicenter study evaluated the overall effectiveness ( as measured by treatment discontinuation rates ) of olanzapine , quetiapine , and risperidone in patients early in the course of psychotic illness . METHOD Patients were r and omly assigned to treatment with olanzapine ( 2.5 - 20 mg/day ) , quetiapine ( 100 - 800 mg/day ) , or risperidone ( 0.5 - 4 mg/day ) administered in twice-daily doses . Statistical analyses tested for noninferiority in all-cause treatment discontinuation rates up to 52 weeks ( primary outcome measure ) based on a prespecified noninferiority margin of 20 % . RESULTS A total of 400 patients were r and omly assigned to treatment with olanzapine ( N=133 ) , quetiapine ( N=134 ) , or risperidone ( N=133 ) . The mean modal prescribed daily doses were 11.7 mg for olanzapine , 506 mg for quetiapine , and 2.4 mg for risperidone . At week 52 , all-cause treatment discontinuation rates were 68.4 % , 70.9 % , and 71.4 % for olanzapine , quetiapine , and risperidone , respectively . Reductions in total score on the Positive and Negative Syndrome Scale ( PANSS ) were similar for the three treatment groups , but reductions in PANSS positive subscale scores were greater in the olanzapine group ( at 12 weeks and at 52 weeks or withdrawal from study ) and the risperidone group ( at 12 weeks ) . The most common elicited adverse events for olanzapine were drowsiness ( 53 % ) , weight gain ( 51 % ) , and insomnia ( 38 % ) ; for quetiapine , drowsiness ( 58 % ) , increased sleep hours ( 42 % ) , and weight gain ( 40 % ) ; and for risperidone , drowsiness ( 50 % ) , menstrual irregularities in women ( 47 % ) , and weight gain ( 41 % ) . CONCLUSIONS Olanzapine , quetiapine , and risperidone demonstrated comparable effectiveness in early-psychosis patients , as indicated by similar rates of all-cause treatment discontinuation
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 .