Atypical antipsychotics and glucose dysregulation: a systematic review.
Atypical antipsychotics (AAP) have been widely used for the management of patients with schizophrenia and other psychotic disorders since they were introduced during the past decade. AAP, as a class, have demonstrated a significant advantage over conventional antipsychotics in clinical efficacy and lower incidence of extrapyramidal symptoms (EPS) and tardive dyskinesia (TD). However, there have been numerous case reports, retrospective studies, epidemiological and clinical data suggesting that certain AAP may be associated with a greater risk of metabolic abnormalities than others, including weight gain, hyperlipidemia, and new-onset type 2 diabetes mellitus (DM) or diabetic ketoacidosis (DKA). In this article, we review and evaluate recent findings addressing the issue of glucose dysregulation associated with AAP therapy along with the recommendations with a recent consensus conference on this issue. Rational patient monitoring guidelines are also elucidated, particularly for high-risk populations that need more intensive scrutiny during treatment of AAP.
Department of Psychiatry, University of California, San Diego VAMC, 3350 La Jolla Village Drive (MC 116A), San Diego, CA 92161, USA. AffectJ@netscape.net
Hua
H
Jin
Jonathan M
JM
Meyer
Dilip V
DV
Jeste
D014150:Antipsychotic Agents / Q000009:adverse effects*; D003920:Diabetes Mellitus / Q000139:chemically induced* / Q000453:epidemiology; D016883:Diabetic Ketoacidosis / Q000453:epidemiology; D006801:Humans; D012559:Schizophrenia / Q000188:drug therapy*
D014150:Antipsychotic Agents