Comparing the safety and efficacy of atypical antipsychotics in psychiatric patients with comorbid medical illnesses.
Patients with severe mental illnesses have a higher risk of premature mortality than the general US population. Illnesses such as schizophrenia and bipolar disorder are frequently complicated by physical comorbidities such as diabetes and cardiovascular disease, including both coronary heart disease and cerebrovascular disease, which are associated with increased mortality and morbidity. Coronary heart disease is the leading cause of death among individuals with severe mental illnesses. Modifiable risk factors such as dyslipidemia, hyperglycemia, hypertension, smoking, and obesity are common in this population and contribute to risk for both diabetes and coronary heart disease. While many psychotropic medications used in the treatment of schizophrenia or bipolar disorder have similar efficacy, some medications are associated with more metabolic side effects than others, and clinicians should consider these risks when choosing among these medications. Patients with severe mental illnesses tend to have reduced access to health care and treatment for medical comorbidities compared with the general population. Therefore, clinicians involved in the care of this patient population should screen and monitor carefully for cardiometabolic side effects and risk factors.
Newcomer
John W
JW
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA. newcomerj@wustl.edu
D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy / Q000401:mortality; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality*; D009765:Obesity / Q000453:epidemiology* / Q000401:mortality; D012559:Schizophrenia / Q000188:drug therapy / Q000401:mortality
D014150:Antipsychotic Agents