Metabolic risks in older adults receiving second-generation antipsychotic medication.
Metabolic syndrome is prevalent in older adults and increases the risk of cardiovascular disease. Second-generation antipsychotics (aripiprazole, clozapine, olanzapine, quetiapine, risperidone, and ziprasidone) increase the risk of metabolic syndrome and present many challenges for psychiatrists. In this article, we review the relationships between second-generation antipsychotics and metabolic syndrome with a focus on older adults. Because few studies focus exclusively on older adults, we augment this review with relevant findings from younger adults. The differential risk factors of each medication are reviewed, as are recent findings in monitoring and treating metabolic syndrome. Olanzapine and clozapine are more strongly associated with metabolic risks, whereas aripiprazole and ziprasidone are less associated. Although lifestyle modifications can help to reduce some aspects of metabolic syndrome, lifestyle modifications in conjunction with metformin therapy appear to be most effective.
Brooks
John O
JO
UCLA Semel Institute, MC 175919, 760 Westwood Plaza, B8-233B NPI, Los Angeles, CA 90024, USA. john.brooks@ucla.edu
Chang
Hye-Sang
HS
Krasnykh
Olya
O
D000341:Affective Disorders, Psychotic / Q000188:drug therapy* / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000517:prevention & control; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000139:chemically induced* / Q000453:epidemiology / Q000517:prevention & control; D008687:Metformin / Q000627:therapeutic use; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000453:epidemiology; D012307:Risk Factors; D015430:Weight Gain / Q000187:drug effects
D014150:Antipsychotic Agents; D007004:Hypoglycemic Agents; D008687:Metformin