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Differential metabolic effects of antipsychotic treatments.
Eur Neuropsychopharmacol. 2006 Sep; 16 Suppl 3:S149-55.EN

Abstract

Metabolic abnormalities such as obesity, diabetes and dyslipidaemia increase the risk of cardiovascular disease, as well as a number of other adverse long-term health consequences. There is increasing evidence from case studies, retrospective analyses and clinical trials to suggest that second-generation antipsychotics can increase the risk of metabolic abnormalities in patients with schizophrenia, with indications that the level of risk may vary among antipsychotic medications. Comparison of weight gain data for the second-generation antipsychotics provides strong evidence to indicate differences in the weight gain liability, with clozapine and olanzapine being associated with the greatest weight gain over 1 year. Data suggest that these treatment-induced changes in weight are primarily responsible for treatment-related changes in glucose metabolism; however, there is also evidence to suggest that some impairments in glucose metabolism may be independent of adiposity. Studies investigating the effects of atypical antipsychotics on glucose metabolism have used a number of techniques of varying sensitivity and quality in an attempt to assign causality. Recent studies using gold standard methodologies, for both insulin sensitivity and adiposity, have shown that psychiatric patients receiving antipsychotics are at least as sensitive to the adverse effects of adiposity on glucose and lipid metabolism as non-psychiatric controls. This demonstrates the importance of weight gain prevention in psychiatry to help reduce long-term risk. There is also growing evidence to suggest that the differential effects of second-generation antipsychotics on metabolic parameters also result in differences in the risk of metabolic syndrome, with olanzapine having a significantly higher risk than either aripiprazole or ziprasidone. This differential risk highlights the need for adequate monitoring in patients receiving treatment with second-generation antipsychotics and careful selection of treatment in high-risk patients.

Authors+Show Affiliations

Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA. hauptd@wustl.edu <hauptd@wustl.edu>

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16872808

Citation

Haupt, Dan W.. "Differential Metabolic Effects of Antipsychotic Treatments." European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology, vol. 16 Suppl 3, 2006, pp. S149-55.
Haupt DW. Differential metabolic effects of antipsychotic treatments. Eur Neuropsychopharmacol. 2006;16 Suppl 3:S149-55.
Haupt, D. W. (2006). Differential metabolic effects of antipsychotic treatments. European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology, 16 Suppl 3, S149-55.
Haupt DW. Differential Metabolic Effects of Antipsychotic Treatments. Eur Neuropsychopharmacol. 2006;16 Suppl 3:S149-55. PubMed PMID: 16872808.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differential metabolic effects of antipsychotic treatments. A1 - Haupt,Dan W, Y1 - 2006/07/25/ PY - 2006/7/29/pubmed PY - 2006/11/15/medline PY - 2006/7/29/entrez SP - S149 EP - 55 JF - European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology JO - Eur Neuropsychopharmacol VL - 16 Suppl 3 N2 - Metabolic abnormalities such as obesity, diabetes and dyslipidaemia increase the risk of cardiovascular disease, as well as a number of other adverse long-term health consequences. There is increasing evidence from case studies, retrospective analyses and clinical trials to suggest that second-generation antipsychotics can increase the risk of metabolic abnormalities in patients with schizophrenia, with indications that the level of risk may vary among antipsychotic medications. Comparison of weight gain data for the second-generation antipsychotics provides strong evidence to indicate differences in the weight gain liability, with clozapine and olanzapine being associated with the greatest weight gain over 1 year. Data suggest that these treatment-induced changes in weight are primarily responsible for treatment-related changes in glucose metabolism; however, there is also evidence to suggest that some impairments in glucose metabolism may be independent of adiposity. Studies investigating the effects of atypical antipsychotics on glucose metabolism have used a number of techniques of varying sensitivity and quality in an attempt to assign causality. Recent studies using gold standard methodologies, for both insulin sensitivity and adiposity, have shown that psychiatric patients receiving antipsychotics are at least as sensitive to the adverse effects of adiposity on glucose and lipid metabolism as non-psychiatric controls. This demonstrates the importance of weight gain prevention in psychiatry to help reduce long-term risk. There is also growing evidence to suggest that the differential effects of second-generation antipsychotics on metabolic parameters also result in differences in the risk of metabolic syndrome, with olanzapine having a significantly higher risk than either aripiprazole or ziprasidone. This differential risk highlights the need for adequate monitoring in patients receiving treatment with second-generation antipsychotics and careful selection of treatment in high-risk patients. SN - 0924-977X UR - https://www.unboundmedicine.com/medline/citation/16872808/Differential_metabolic_effects_of_antipsychotic_treatments_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0924-977X(06)00107-6 DB - PRIME DP - Unbound Medicine ER -