PMID- 24103643
OWN - NLM
STAT- MEDLINE
DCOM- 20140825
LR  - 20220330
IS  - 1741-203X (Electronic)
IS  - 1041-6102 (Linking)
VI  - 26
IP  - 1
DP  - 2014 Jan
TI  - A systematic review of metabolic side effects related to the use of antipsychotic 
      drugs in dementia.
PG  - 19-37
LID - 10.1017/S1041610213001658 [doi]
AB  - BACKGROUND: In clinical practice, Second Generation Antipsychotics (SGAs) are 
      often used as first-line treatment for the Behavioral and Psychological Symptoms 
      of Dementia (BPSD) in older adults due to their fewer neurological adverse events 
      and similar effectiveness compared with First Generation Antipsychotics (FGAs). 
      SGAs, however, are associated with more severe metabolic side effects (weight 
      gain, hyperglycemia, diabetes risk, and hyperlipidemia) than FGAs are. In 
      general, older patients, especially those affected by dementia, are at increased 
      risk for malnutrition, and tend to have lower basal metabolism and reduced liver 
      and kidney function. However, little is known about the metabolic side effects of 
      antipsychotic drugs in this population. METHODS: A comprehensive review of the 
      literature published between January 1996 and December 2012 investigating the 
      metabolic side effects related to FGAs and SGAs use in old patients affected by 
      dementia. RESULTS: Antipsychotic drugs currently used to treat BPSD in subjects 
      with mild to moderate dementia are associated with weight gain. Currently, there 
      are insufficient data to support a causal relationship between the use of FGAs 
      and SGAs and changes in glucose homeostasis or lipid metabolism in older persons 
      affected by severe dementia (MMSE <14). CONCLUSION: A possible association 
      between antipsychotic drugs use and weight gain might exist, in particular in 
      subjects with mild to moderate dementia whereas no significant effects are 
      demonstrated regarding glucose homeostasis and lipid metabolism. The 
      antipsychotic drugs potential for causing metabolic abnormalities in older 
      patients requires further specifically designed studies. Clinicians must be aware 
      of this possibility even if the shorter periods of treatment administered in 
      late-life might not be as harmful as it is in younger individuals.
FAU - Atti, A R
AU  - Atti AR
AD  - Department of Biomedical and Neuromotor Science, Section of Psychiatry, 
      University of Bologna, Bologna, Italy.
FAU - Ferrari Gozzi, B
AU  - Ferrari Gozzi B
FAU - Zuliani, G
AU  - Zuliani G
FAU - Bernabei, V
AU  - Bernabei V
FAU - Scudellari, P
AU  - Scudellari P
FAU - Berardi, D
AU  - Berardi D
FAU - De Ronchi, D
AU  - De Ronchi D
FAU - Tarricone, I
AU  - Tarricone I
FAU - Menchetti, M
AU  - Menchetti M
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
DEP - 20131009
PL  - England
TA  - Int Psychogeriatr
JT  - International psychogeriatrics
JID - 9007918
RN  - 0 (Antipsychotic Agents)
RN  - 0 (Lipids)
SB  - IM
MH  - Aged
MH  - Antipsychotic Agents/*adverse effects/therapeutic use
MH  - Dementia/*drug therapy/metabolism
MH  - Glucose Metabolism Disorders/chemically induced
MH  - Homeostasis/drug effects
MH  - Humans
MH  - Lipid Metabolism/*drug effects
MH  - Lipids/blood
MH  - Metabolic Diseases/*chemically induced
MH  - Metabolism/drug effects
MH  - Weight Gain/drug effects
EDAT- 2013/10/10 06:00
MHDA- 2014/08/26 06:00
CRDT- 2013/10/10 06:00
PHST- 2013/10/10 06:00 [entrez]
PHST- 2013/10/10 06:00 [pubmed]
PHST- 2014/08/26 06:00 [medline]
AID - S1041610213001658 [pii]
AID - 10.1017/S1041610213001658 [doi]
PST - ppublish
SO  - Int Psychogeriatr. 2014 Jan;26(1):19-37. doi: 10.1017/S1041610213001658. Epub 
      2013 Oct 9.