The role of atypical antipsychotics in glucose/insulin dysregulation and the evolving role of the psychiatrist in a new era of drug treatment options.
This article examines the issue of atypical antipsychotics, glucose/insulin, and other metabolic derangements (ie, metabolic syndrome), including a general introduction to the health concerns of our patients, a review of the literature, possible mechanisms of antipsychotic induced glucose dysregulation, monitoring approaches, and management and prevention of metabolic syndrome. Literature review leads to mechanism hypotheses and risk estimations, leading to guidelines for monitoring and treatment. The patient population suffers from a higher degree of baseline metabolic dysregulation resulting in cardiovascular disease through components of the metabolic syndrome, and this risk increases with administration of atypical antipsychotic medication at different rates, depending on both drug and patient risk factors. The growing knowledge of mechanisms behind drug induced glucose/insulin and other metabolic dysregulation, as well as advances in pharmacogenomics, will help refine drug selection and monitoring for adverse, life-threatening metabolic effects.
Ferraioli
Anthony
A
Albany County Department of Mental Health, Albany, NY, USA. af92@nycap.rr.com
Shirley
Kara Lee
KL
David
Panakkal
P
D000367:Age Factors; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D006949:Hyperlipidemias / Q000139:chemically induced* / Q000378:metabolism*; D007328:Insulin / Q000378:metabolism*; D008297:Male; D010819:Physician's Role; D011570:Psychiatry / Q000379:methods*; D011618:Psychotic Disorders / Q000188:drug therapy*; D012307:Risk Factors; D015430:Weight Gain
D014150:Antipsychotic Agents; D007328:Insulin; D005947:Glucose