Atypical antipsychotics (AAP) are associated with adverse effects such as weight gain and the metabolic syndrome. Weight gain is an important marker to control while using AAP. Our study shows the existent correlations between weight gain, the decrease of neuroprotection and cognitive impairment.

A retrospective study on 16 patients, 10 women and 6 men, diagnosed with schizophrenia (DSM-IV) and multiple episodes (>5 episodes in 3 years) being under treatment with typical antipsychotics (minimum 3 cures, more than 6 months each) and to whom was imposed the switch to atypical antipsychotics because of the poor therapeutical respondence. None of the patients presented EPS of whose intensity to necessitate this switch. After the initiation of the AAP therapy they presented a significant weight gain (>15% of the ideal weight in the first 12 months).

These patients were monitorized for:

1. - social distress factors;

2. - the cognitive evaluation using California Verbal Learning Test;

3. - neuroimagistic evaluation (CT);

4. - PANSS.

All the patients presented a high familial and social distress factors, cognitive impairment and neuroimagistic modifications in cortical areas and ventricular enlargement. On the PANSS scale observing a decrease in intensity of the positive symptoms, and an insignificant modification of the negative symptoms.

The significant weight gain during the first year after the switch to AAP to these patients, can serve as a marker for neurostructural changes, neuroimagistic monitorization being obligatory at the moment of the decision of switching from a typical to an atypical antipsychotic.