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Adverse metabolic effects associated with atypical antipsychotics: literature review and clinical implications.
Drugs. 2004; 64(7):701-23.D

Abstract

Adverse metabolic effects, such as diabetes mellitus, lipid abnormalities and weight gain, have increasingly been recognised with the use of the newer, so-called atypical antipsychotic drugs. This article reviews the current literature in the field and attempts to answer the question of whether the atypical antipsychotics differ in their effects on glucose-insulin homeostasis and lipid metabolism. It also addresses how then to manage the use of the atypical antipsychotics that do interfere with these metabolic systems. Differences in effects of atypical antipsychotics on leptin levels are also summarised and put into context; bodyweight gain associated with atypical antipsychotics is reviewed elsewhere. In summary, there are no large controlled trials published quantifying the prevalence of adverse effects on glucose-insulin homeostasis and lipid metabolism in patients receiving atypical antipsychotics. Nevertheless, the published articles and case reports reviewed in this article give a fairly good view of those adverse effects occurring with clozapine, olanzapine and risperidone, whereas little data are available regarding quetiapine, ziprasidone and zotepine, and no data exist for amisulpride and aripiprazole. Estimated rankings of the atypical agents, based on the available literature, show that the relative risk of glucose intolerance/diabetes mellitus, hyperlipidaemia and hyperleptinaemia is highest for clozapine and olanzapine, moderately high for quetiapine, rather low for risperidone and lowest for ziprasidone. Since adverse metabolic effects of atypical antipsychotics may have a negative influence on both the antipsychotic treatment outcome as well as the physical health of the patient, these effects have to be recognised and adequately managed. In this review, recommendations for prevention and treatment of the adverse metabolic effects are outlined.

Authors+Show Affiliations

Psychiatric Polyclinic, Sollentuna Hospital, Nytorpsvägen 10-12, SE-191 35 Sollentuna, Sweden. Kristina.Melkersson@cns.ki.seNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

15025545

Citation

Melkersson, Kristina, and Marja-Liisa Dahl. "Adverse Metabolic Effects Associated With Atypical Antipsychotics: Literature Review and Clinical Implications." Drugs, vol. 64, no. 7, 2004, pp. 701-23.
Melkersson K, Dahl ML. Adverse metabolic effects associated with atypical antipsychotics: literature review and clinical implications. Drugs. 2004;64(7):701-23.
Melkersson, K., & Dahl, M. L. (2004). Adverse metabolic effects associated with atypical antipsychotics: literature review and clinical implications. Drugs, 64(7), 701-23.
Melkersson K, Dahl ML. Adverse Metabolic Effects Associated With Atypical Antipsychotics: Literature Review and Clinical Implications. Drugs. 2004;64(7):701-23. PubMed PMID: 15025545.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adverse metabolic effects associated with atypical antipsychotics: literature review and clinical implications. AU - Melkersson,Kristina, AU - Dahl,Marja-Liisa, PY - 2004/3/18/pubmed PY - 2004/8/7/medline PY - 2004/3/18/entrez SP - 701 EP - 23 JF - Drugs JO - Drugs VL - 64 IS - 7 N2 - Adverse metabolic effects, such as diabetes mellitus, lipid abnormalities and weight gain, have increasingly been recognised with the use of the newer, so-called atypical antipsychotic drugs. This article reviews the current literature in the field and attempts to answer the question of whether the atypical antipsychotics differ in their effects on glucose-insulin homeostasis and lipid metabolism. It also addresses how then to manage the use of the atypical antipsychotics that do interfere with these metabolic systems. Differences in effects of atypical antipsychotics on leptin levels are also summarised and put into context; bodyweight gain associated with atypical antipsychotics is reviewed elsewhere. In summary, there are no large controlled trials published quantifying the prevalence of adverse effects on glucose-insulin homeostasis and lipid metabolism in patients receiving atypical antipsychotics. Nevertheless, the published articles and case reports reviewed in this article give a fairly good view of those adverse effects occurring with clozapine, olanzapine and risperidone, whereas little data are available regarding quetiapine, ziprasidone and zotepine, and no data exist for amisulpride and aripiprazole. Estimated rankings of the atypical agents, based on the available literature, show that the relative risk of glucose intolerance/diabetes mellitus, hyperlipidaemia and hyperleptinaemia is highest for clozapine and olanzapine, moderately high for quetiapine, rather low for risperidone and lowest for ziprasidone. Since adverse metabolic effects of atypical antipsychotics may have a negative influence on both the antipsychotic treatment outcome as well as the physical health of the patient, these effects have to be recognised and adequately managed. In this review, recommendations for prevention and treatment of the adverse metabolic effects are outlined. SN - 0012-6667 UR - https://www.unboundmedicine.com/medline/citation/15025545/Adverse_metabolic_effects_associated_with_atypical_antipsychotics:_literature_review_and_clinical_implications_ L2 - https://dx.doi.org/10.2165/00003495-200464070-00003 DB - PRIME DP - Unbound Medicine ER -