title: Pharmacological treatment of antipsychotic-induced dyslipidemia and hypertension.
abstract: Second-generation antipsychotics (SGAs) are associated with significant comorbid metabolic abnormalities. Adjunct medications may be prescribed to treat these metabolic side effects, but the evidence supporting this practice (especially for the management of antipsychotic-associated dyslipidemia and hypertension) is limited. The purpose of this review was to evaluate the effects of adjunct medications on triglyceride, total cholesterol, low-density lipoprotein, high-density lipoprotein, and blood pressure levels in participants taking SGAs for psychosis. Studies were systematically searched and evaluated. Studies were included for review if participants were taking SGAs and if lipid and/or blood pressure levels were included as outcome measures. Statins, conventional lipid-lowering agents, fluvoxamine, ramelteon, topiramate, valsartan, telmisartan, omega-3 fatty acids, metformin (including both immediate-release and extended-release formulations), and a combination of metformin-sibutramine seemed to have beneficial effects on lipid levels. Valsartan, telmisartan, and topiramate appeared to be effective for controlling increases in blood pressure. The literature on adjunct medications for the treatment of antipsychotic-associated dyslipidemia and hypertension is not exhaustive, and long-term randomized-controlled trials would offer valuable results.
authors.affiliation: Departments of aAnesthesiology, Pharmacology & Therapeutics bPsychiatry, University of British Columbia cBC Mental Health and Addictions Research Institute, Vancouver, British Columbia, Canada.
authors.forename: Lurdes
authors.initials: L
authors.lastname: Tse
authors.forename: Ric M
authors.initials: RM
authors.lastname: Procyshyn
authors.forename: Diane H
authors.initials: DH
authors.lastname: Fredrikson
authors.forename: Heidi N
authors.initials: HN
authors.lastname: Boyda
authors.forename: William G
authors.initials: WG
authors.lastname: Honer
authors.forename: Alasdair M
authors.initials: AM
authors.lastname: Barr
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects*; D050171:Dyslipidemias / Q000139:chemically induced* / Q000188:drug therapy*; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D044094:Receptors, Melatonin / Q000819:agonists; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D000927:Anticonvulsants; D014150:Antipsychotic Agents; D044094:Receptors, Melatonin; D017367:Selective Serotonin Reuptake Inhibitors