Metabolic side effects of antipsychotic medication

Summary The use of second‐generation antipsychotics (SGAs) is associated with metabolic side effects including weight gain, diabetes mellitus and an atherogenic lipid profile. These adverse effects are not only the risk factors for cardiovascular disease, insulin resistance and diabetes mellitus lea...

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Bibliographic Details
Published in:International journal of clinical practice (Esher) 2007-08, Vol.61 (8), p.1356-1370
Main Authors: Tschoner, A., Engl, J., Laimer, M., Kaser, S., Rettenbacher, M., Fleischhacker, W. W., Patsch, J. R., Ebenbichler, C. F.
Format: Article
Language:English
Subjects:
Antipsychotic Agents - adverse effects
Female
Humans
Male
Metabolic Diseases - chemically induced
Patient Compliance
Psychotic Disorders - drug therapy
Risk Factors
Schizophrenia - drug therapy
Weight Gain - drug effects
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Summary:Summary The use of second‐generation antipsychotics (SGAs) is associated with metabolic side effects including weight gain, diabetes mellitus and an atherogenic lipid profile. These adverse effects are not only the risk factors for cardiovascular disease, insulin resistance and diabetes mellitus leading to increased morbidity and mortality but may also impair the patient's adherence to treatment. SGAs in particular are associated with significant weight gain with clozapine and olanzapine carrying the highest risk, whereas newer agents, such as risperidone and aripiprazole, are considered to be less prone to cause weight gain. Consequently, a consensus development conference convened issuing recommendations on patient monitoring when treated with SGAs. The metabolic effects of antipsychotic drugs should be of concern when planning a patient's treatment strategy. Baseline screening and regular follow‐up monitoring whose intervals should depend on the individual predisposition are advised. Possible therapeutical strategies for the management of drug‐induced obesity include therapeutic approaches, such as life style change and pharmaceutical intervention. Drugs with a weight reducing effect become more important because of the lack of compliance with behavioural intervention. Topiramate, histamine‐antagonists, dopaminergic‐ and serotoninergic agents have shown positive results in the management of psychotropic medication induced weight gain. However, further trials are required to support a specific therapeutical approach as well as studies to investigate the underlying mechanisms for future drug development.
ISSN:1368-5031
1742-1241
DOI:10.1111/j.1742-1241.2007.01416.x