Compared with first-generation antipsychotics, second-generation antipsychotics are more strongly associated with which group of metabolic abnormalities?

Compared with first-generation antipsychotics, second-generation antipsychotics are more strongly associated with which group of metabolic abnormalities?

• A. Second-Generation Antipsychotics
• B. First-Generation, High-Potency
• C. First-Generation, Low-Potency
• D. Antidepressants

Answer: (A)

The main concept here is that metabolic disturbances—weight gain, dyslipidemia, and insulin resistance leading to metabolic syndrome—are more strongly linked to second-generation antipsychotics than to first-generation ones. This higher metabolic risk with SGAs is thought to arise from their effects on appetite and energy balance, particularly through blockade of serotonin 5-HT2C and histamine H1 receptors, which increases appetite and weight, and can impact glucose and lipid metabolism. Within the class, some agents (like olanzapine and clozapine) have the greatest metabolic risk, while others vary in their impact, but the overall pattern remains: SGAs are more prone to metabolic abnormalities than FGAs. By contrast, first-generation antipsychotics are more associated with extrapyramidal symptoms and neuroleptic effects rather than metabolic syndrome. Thus, the group most strongly associated with metabolic abnormalities is second-generation antipsychotics.

The main concept here is that metabolic disturbances—weight gain, dyslipidemia, and insulin resistance leading to metabolic syndrome—are more strongly linked to second-generation antipsychotics than to first-generation ones. This higher metabolic risk with SGAs is thought to arise from their effects on appetite and energy balance, particularly through blockade of serotonin 5-HT2C and histamine H1 receptors, which increases appetite and weight, and can impact glucose and lipid metabolism. Within the class, some agents (like olanzapine and clozapine) have the greatest metabolic risk, while others vary in their impact, but the overall pattern remains: SGAs are more prone to metabolic abnormalities than FGAs. By contrast, first-generation antipsychotics are more associated with extrapyramidal symptoms and neuroleptic effects rather than metabolic syndrome. Thus, the group most strongly associated with metabolic abnormalities is second-generation antipsychotics.