Management of schizophrenia with obesity, metabolic, and endocrinological disorders.
People with schizophrenia have an increased prevalence of overweight/obesity, type 2 diabetes mellitus, dyslipidemia, and metabolic syndrome, which increases the risk for cardiovascular diseases and mortality. Part of this increased risk is attributable to the use of antipsychotic medications, especially second-generation antipsychotics. Antipsychotic drugs differ in their potential to induce weight gain, with clozapine and olanzapine exhibiting the highest weight gain liability; evidence for differing effects of antipsychotics on glucose and lipid metabolism is less convincing. Individuals with schizophrenia may develop hyperprolactinemia, with or without clinical symptoms, after starting antipsychotic medications. This effect is particularly frequent with first-generation antipsychotics and with the second-generation antipsychotic risperidone and paliperidone. Psychiatrists should be aware of metabolic and endocrine side effects of antipsychotics and should make every effort to prevent or minimize them to improve the patients' compliance and quality of life.
Monteleone
Palmiero
P
Department of Psychiatry, University of Naples SUN, Naples, Largo Madonna delle Grazie, 80138, Napoli, Italy. monteri@tin.it
Martiadis
Vassilis
V
Maj
Mario
M
D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D048909:Diabetes Complications / Q000139:chemically induced / Q000628:therapy; D050171:Dyslipidemias / Q000139:chemically induced / Q000150:complications* / Q000628:therapy; D006801:Humans; D006966:Hyperprolactinemia / Q000139:chemically induced / Q000150:complications / Q000188:drug therapy; D024821:Metabolic Syndrome / Q000139:chemically induced / Q000150:complications* / Q000628:therapy; D009765:Obesity / Q000139:chemically induced / Q000150:complications* / Q000628:therapy; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy*; D015430:Weight Gain
D014150:Antipsychotic Agents