This study investigated the risk-profile of different second-generation antipsychotics (SGAs) for the treatment of schizophrenia through a meta-analysis by assessing variations between the start of treatment and the end of follow-up.

Olanzapine and risperidone reported the greatest weight gain and olanzapine the largest BMI increase. Paliperidone showed the highest increase in total cholesterol, but is the only drug reporting an increase in the HDL cholesterol. Quetiapine XR showed the highest decrease in fasting glucose. Lurasidone showed the lowest increase in body weight and a reduction in BMI and was also the only treatment reporting a decrease in total cholesterol and triglycerides. The highest increase in systolic and diastolic blood pressure was reported by quetiapine XR.

The evidence on the metabolic risk profile of SGAs may support clinicians in the selection of the appropriate treatment for each patient and the development of economic evaluation studies.