PMID- 15823759
OWN - NLM
STAT- MEDLINE
DCOM- 20050428
LR  - 20220318
IS  - 0149-2918 (Print)
IS  - 0149-2918 (Linking)
VI  - 26
IP  - 12
DP  - 2004 Dec
TI  - Metabolic risk during antipsychotic treatment.
PG  - 1936-46
AB  - BACKGROUND: Compared with the general population, individuals with schizophrenia 
      demonstrate an increased prevalence of obesity, type 2 diabetes mellitus (T2DM), 
      and cardiovascular disease (CVD). Increased adiposity is associated with 
      decreases in insulin sensitivity, leading to an increased risk of hyperglycemia 
      and hyperlipidemia. Antipsychotic medications can increase adiposity, and a range 
      of evidence from case reports, observational studies, retrospective database 
      analyses, and controlled experimental studies (including randomized clinical 
      trials) suggests that treatment with antipsychotic medications may be associated 
      with an increased risk for insulin resistance, hyperglycemia, dyslipidemia, and 
      T2DM. OBJECTIVE: This article reviews current evidence for the hypothesis that 
      treatment with antipsychotic medications may be associated with increased risks 
      for weight gain, insulin resistance, hyperglycemia, dyslipidemia, and T2DM, and 
      examines the relationship of adiposity to medical risk. METHODS: Relevant 
      publications were identified through a search of MEDLINE from 1975 to the present 
      using the primary search parameters "diabetes or hyperglycemia or glucose or 
      insulin or lipids" and "antipsychotic." Meeting abstracts and earlier nonindexed 
      articles concerning antipsychotic-associated weight gain and metabolic 
      disturbance were also reviewed. Key studies in this emerging literature were 
      summarized, including case reports, observational studies, retrospective database 
      analyses, and controlled experimental studies. RESULTS: Individual antipsychotic 
      medications are associated with different degrees of treatment-induced increases 
      in body weight and adiposity, ranging from modest effects (<2 kg) with 
      amisulpride, ziprasidone, and aripiprazole to clinically significant increases 
      with olanzapine (4-10 kg). In addition to strong evidence concerning the effect 
      of adiposity on insulin sensitivity in nonpsychiatric populations, increased 
      adiposity in patients with schizophrenia has been associated with decreases in 
      insulin sensitivity; this and other effects may contribute to increases in plasma 
      glucose concentrations and lipid levels. CONCLUSION: Metabolic changes in 
      psychiatric patients who receive antipsychotic agents can contribute to the 
      development of the metabolic syndrome and increase the risk for T2DM and CVD.
FAU - Newcomer, John W
AU  - Newcomer JW
AD  - Department of Psychiatry, Washington University School of Medicine, 660 South 
      Euclid Avenue, St. Louis, MO 63110, USA. newcomerj@psychiatry.wustl.edu
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - Clin Ther
JT  - Clinical therapeutics
JID - 7706726
RN  - 0 (Antipsychotic Agents)
SB  - IM
MH  - Antipsychotic Agents/*adverse effects
MH  - Cardiovascular Diseases/*chemically induced
MH  - Diabetes Mellitus, Type 2/*chemically induced
MH  - Humans
MH  - Obesity/*chemically induced
MH  - Randomized Controlled Trials as Topic
MH  - Risk
MH  - Schizophrenia/*drug therapy
MH  - Weight Gain/drug effects
RF  - 84
EDAT- 2005/04/13 09:00
MHDA- 2005/04/29 09:00
CRDT- 2005/04/13 09:00
PHST- 2004/11/24 00:00 [accepted]
PHST- 2005/04/13 09:00 [pubmed]
PHST- 2005/04/29 09:00 [medline]
PHST- 2005/04/13 09:00 [entrez]
AID - S0149-2918(04)00073-6 [pii]
AID - 10.1016/j.clinthera.2004.12.003 [doi]
PST - ppublish
SO  - Clin Ther. 2004 Dec;26(12):1936-46. doi: 10.1016/j.clinthera.2004.12.003.