Risperidone induced weight gain leading to benign intracranial hypertension

Benign intracranial hypertension (BIH) is a condition which is strongly associated with weight gain. A well-known potential adverse effect of anti-psychotic treatment, especially the atypical group, is weight gain. Our case describes the use of risperidone in a young obese lady who gained significant weight after commencing the antipsychotic and later developed headache and blurred vision. Withdrawing the offending drug (causing reduction in her weight) in addition to acetazolamide drastically improved her symptoms within a month. Our case highlights that, obese patients started on antipsychotic medication, who develop headache, should be considered for investigation of BIH.