Which statement best describes the metabolic side effects associated with second-generation antipsychotics?

• A. Weight gain, increased glucose, lipid abnormalities
• B. Weight loss, decreased glucose, lipid normalization
• C. No metabolic changes
• D. Reduced appetite only

Answer: (A)

Metabolic side effects with second-generation antipsychotics commonly present as weight gain together with higher blood glucose and abnormal lipid levels. The weight gain is partly driven by receptor effects in the brain, especially blockade of histamine H1 and serotonin 5-HT2C receptors, which increase appetite. These drugs can also impair insulin sensitivity and affect lipid metabolism, leading to elevated fasting glucose and dyslipidemia. Taken together, they raise the risk of metabolic syndrome and cardiovascular disease. So the best choice reflects this pattern: weight gain with increased glucose and lipid abnormalities. Other options don’t fit because they describe weight loss, no metabolic changes, or only reduced appetite, which don’t capture the typical and clinically important metabolic profile of these medications. Monitoring should include baseline and periodic checks of weight/BMI, fasting glucose or HbA1c, and lipid panels.