Schizophrenia and comorbid metabolic disorders.
Comorbid metabolic disorders in patients with schizophrenia are underrecognized by many health care professionals and patients. That lack of awareness can contribute to serious morbidity and mortality in patients with schizophrenia. Patients with schizophrenia may be at greater risk for metabolic disorders such as insulin resistance, lipid abnormalities, and weight gain. In addition, although the use of atypical antipsychotics in the treatment of schizophrenia offers many positive benefits and may reduce some of the factors related to the morbidity and mortality of the disorder, these drugs appear to be associated with varying degrees of comorbid metabolic disorders, such as metabolic syndrome, and more serious consequences, such as cardiovascular disease. Recent consensus guidelines recommend that metabolic risks be considered when initiating therapy with atypical antipsychotics. Thus, baseline screening and routine monitoring of patient weight, fasting lipid profile, and fasting plasma glucose are essential. In addition, optimal treatment for patients with schizophrenia and comorbid metabolic disorders is best achieved when all parties involved with patient care (mental health and medical community, caregiver/family, and patient) communicate and work together. With proper awareness and cooperation on the part of the medical community, caregivers, and patients, the detrimental consequences that may result from the metabolic disorders addressed in this article can be at least partially offset.
Henderson
David C
DC
Schizophrenia Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. dhenderson@partners.org
D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D015897:Comorbidity; D044882:Glucose Metabolism Disorders / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D006949:Hyperlipidemias / Q000139:chemically induced / Q000453:epidemiology; D006966:Hyperprolactinemia / Q000139:chemically induced / Q000453:epidemiology; D008659:Metabolic Diseases / Q000139:chemically induced / Q000453:epidemiology*; D009765:Obesity / Q000139:chemically induced / Q000453:epidemiology; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy / Q000453:epidemiology*
D014150:Antipsychotic Agents