Which pair has the lowest metabolic risk among commonly used antipsychotics?

Which pair has the lowest metabolic risk among commonly used antipsychotics?

• A. Clozapine and Olanzapine
• B. Quetiapine and Risperidone
• C. Ziprasidone and Aripiprazole
• D. Lurasidone and Iloperidone

Answer: (B)

Metabolic risk with antipsychotics is driven mainly by weight gain and effects on glucose and lipid metabolism. Some agents, like clozapine and olanzapine, tend to cause substantial weight gain and dyslipidemia, increasing the risk of metabolic syndrome. Others have much lower metabolic impact. Ziprasidone and aripiprazole are known for being weight neutral or having only minimal effects on weight, glucose, and lipids. This combination therefore carries the lowest metabolic burden among commonly used antipsychotics. It’s important to balance this with other safety factors for each drug—ziprasidone can cause QT prolongation, and aripiprazole can cause akathisia—but in terms of metabolic risk, they stand out as the mildest among the options.

Metabolic risk with antipsychotics is driven mainly by weight gain and effects on glucose and lipid metabolism. Some agents, like clozapine and olanzapine, tend to cause substantial weight gain and dyslipidemia, increasing the risk of metabolic syndrome. Others have much lower metabolic impact.

Ziprasidone and aripiprazole are known for being weight neutral or having only minimal effects on weight, glucose, and lipids. This combination therefore carries the lowest metabolic burden among commonly used antipsychotics. It’s important to balance this with other safety factors for each drug—ziprasidone can cause QT prolongation, and aripiprazole can cause akathisia—but in terms of metabolic risk, they stand out as the mildest among the options.