Antipsychotic Drugs: From Receptor-binding Profiles to Metabolic Side Effects

Abstract

Emerging evidence suggests that antipsychotics have different liabilities to induce obesity, diabetes and dyslipidemia. However this diversity cannot be explained merely by drugs'pharmacodynamic profiles, highlighting the need for further research.

Detecting a potential safety signal of antidepressants and type 2 diabetes: a pharmacovigilance‐pharmacodynamic study

“…Adrenergic and dopaminergic signalling may also play important roles in metabolic side effects. Τhe net result is a complex interplay between central and peripheral mechanisms [3,28]. In accordance with…”

“…Other antidepressants with high occupancies on H 1 , such as trimipramine, maprotiline and desipramine, had small and potentially insufficient numbers of reports in order to raise disproportionality signals. The role of 5-HT 2A/C antagonism has also been suggested in psychotropic-induced diabetes, especially in antipsychotics [3,4]. However, a significant correlation was not observed, which is also supported by the fact that nefazodone and trazodone were not associated with diabetes.…”

“…The better-studied antipsychotics could provide insights on the possible mechanisms of antidepressant-induced diabetes. Several receptor mechanisms of antipsychotic-induced metabolic side effects have been suggested, such as antagonism of dopamine, histamine, muscarinic and serotonin receptors [3]. A recent pharmacoepidemiological-pharmacodynamic study in VigiBase suggested that antipsychotics with H 1 and 5-HT 2C antagonistic properties were associated with diabetes [4].…”

Pimavanserin: A Novel Antipsychotic With Potentials to Address an Unmet Need of Older Adults With Dementia-Related Psychosis

“…The efficacy of pimavanserin for treating hallucinations and delusions associated with Parkinson's disease was demonstrated in a 6-week, randomized, placebo-controlled, parallel-group phase III study by Cummings et al The study randomized 199 patients (mean age 72 years) with Parkinson's disease psychosis (hallucinations and/or delusions) to receive either pimavanserin 34 mg daily or placebo. The outcome was assessed with the (Nasrallah, 2008;Hacksell et al, 2014;Mauri et al, 2014;Kusumi et al, 2015;Siafis et al, 2018).…”

Psychopharmaka-induzierte unerwünschte Wirkungen in der Ernährungstherapie

“…Entsprechend häufig sind ernährungstherapeutisch behandelte Patienten, die eine (Ko-)Medikation mit Psychopharmaka erhalten. Umgekehrt suchen Patienten auch ernährungstherapeutischen Rat aufgrund unerwünschter Wirkungen der Psychopharmakatherapie [5].…”