Metabolic changes associated with antipsychotic use

Abstract

In the United States, the risk of type 2 diabetes is currently growing to epidemic proportions, with many physicians unaware that disorders such as schizophrenia and bipolar disorder naturally place patients at an increased risk for diabetes. Another serious concern for physicians is the development of metabolic syndrome, also known as syndrome X, in patients suffering from schizophrenia. Metabolic syndrome often encompasses medical conditions such as weight gain, hypertriglyceridemia, and increased insulin, glucose, and low-density lipoprotein cholesterol levels. Treatment with atypical antipsychotics may increase the risk of metabolic syndrome and diabetes, and physicians need to be proactive when treating patients with schizophrenia. Physicians should be aware that the treatment of schizophrenia involves the right balance for the patient in terms of adverse effects versus benefit, and failing to treat a patient's mental illness because of potential medical problems may place the patient at an increased risk for more serious problems.

Figure 1.

Weight Gain as a Function of Drug^a

Figure 2.

Plasma Glucose Values at Fasting and Postload Time Points^a

Figure 3.

Percentage of Patients With Schizophrenia Receiving Prescriptions for Atypical and Typical Neuroleptic Medication Who Also Had a Diagnosis of Diabetes Mellitus^a