What metabolic side effects are associated with second-generation antipsychotics?

• A. Nausea and Vomiting
• B. Hair Loss
• C. Weight gain, increased glucose, lipid abnormalities
• D. Sleep Disturbance

Answer: (C)

Metabolic side effects are a key concern with second-generation antipsychotics. These drugs can shift body weight and disrupt metabolic processes, leading to weight gain, elevated blood glucose, and abnormal lipid levels. The underlying reason lies in their receptor effects: antagonism at 5-HT2C and histamine H1 receptors increases appetite and weight, while changes in insulin sensitivity and lipid metabolism contribute to dysglycemia and dyslipidemia. Some agents carry a heavier burden (like olanzapine and clozapine), while others have a comparatively lower risk (such as aripiprazole or ziprasidone), but all can impact metabolism to some degree. This combination—weight gain plus impaired glucose and lipid profiles—best reflects the metabolic syndrome risk associated with these medications.

Other options describe effects that are not primarily metabolic in nature (gastrointestinal upset, hair loss, or sleep disturbance), so they don’t capture the characteristic metabolic side effect profile.