Which pair of antipsychotics carries the HIGHEST risk of clinically significant weight gain and new-onset type 2 diabetes?

• A Clozapine and olanzapine ✓
• B Risperidone and paliperidone
• C Haloperidol and fluphenazine
• D Ziprasidone and aripiprazole

Explanation

Clozapine and olanzapine rank highest for metabolic adverse effects: weight gain, dyslipidemia, and insulin resistance requiring regular glucose and lipid monitoring. Risperidone and quetiapine are intermediate, while ziprasidone and aripiprazole are metabolically the safest agents. High-potency typicals such as haloperidol cause minimal weight gain but carry higher extrapyramidal risk. Histamine H1 and 5-HT2C antagonism are thought to drive the appetite increase seen with clozapine and olanzapine.

Reference: Katzung Basic and Clinical Pharmacology, 15th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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