Clinical monitoring and management of the metabolic syndrome in patients receiving atypical antipsychotic medications

Hasnain, Mehrul; Vieweg, W. Victor R.; Fredrickson, Sonja K.; Beatty-Brooks, Mary; Fernandez, Antony; Pandurangi, Anand K.

doi:10.1016/j.pcd.2008.10.005

Cited by 72 publications

(53 citation statements)

References 95 publications

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“…Despite the advantages of treatment with OLZ, the reported side effects including, weight gain, impaired glucose metabolism and dyslipidemia, elevated liver enzymes and hepatotoxicity should be taken into account (26,27). Therefore, it is extremely important to prevent adverse effects and other metabolic disorders induced by OLZ.…”

Section: Discussionmentioning

confidence: 99%

The protective effect of thymoquinone over olanzapine-induced side effects in liver, and metabolic side effects

Bilğiç¹,

Korkmaz²,

Azırak³

et al. 2018

BLL

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OBJECTIVES: The aim of the study was to investigate the possible protective qualities of thymoquinone (TQ) against the side-effects of olanzapine (OLZ) in an experimental model in rat liver with histologic and biochemical assessments. METHODS: Experimental procedures were performed on 35 female Sprague Dawley rats. Rats were randomly divided into fi ve groups as: group 1: control; group 2: OLZ; group 3: OLZ+TQ-1; group 4: OLZ+TQ-2; and group 5: OLZ+TQ-3. RESULTS: The results showed that a 2-week administration of OLZ (4 mg/kg, once a day for the fi rst week, 8 mg/kg once a day for the second week, p.o.) and treatment with TQ (25, 50, 100 mg/kg, once daily, p.o.) signifi cantly reduced weight gain induced by OLZ. In addition, TQ increased the total antioxidant status (TAS), high-density lipoprotein cholesterol (HDL), insulin levels and decreased serum oxidative stress index (OSI), total oxidant status (TOS), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transpeptidase (GGT), low density lipoprotein cholesterol (LDL), glucose, triglycerides (TG) and total cholesterol (CH) levels signifi cantly (p < 0.05). CONCLUSION: This study revealed that treatment with TQ might protect liver tissue against the side-effects of OLZ. TQ could be an effective course of therapy to enhance therapeutic effi cacy (Tab. 4, Fig. 4, Ref. 47). Text in PDF www.elis.sk.

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Section: Discussionmentioning

confidence: 99%

The protective effect of thymoquinone over olanzapine-induced side effects in liver, and metabolic side effects

Bilğiç¹,

Korkmaz²,

Azırak³

et al. 2018

BLL

View full text Add to dashboard Cite

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“…They recommend that patients on antipsychotics monitor their body weight, dietary habits, waist circumference, blood pressure and fasting plasma glucose etc during the course of their SGA treatment (reviewed in [126,[128][129] ). When metabolic symptoms are obvious, one option is to switch from a high weight gain liability drug such as olanzapine to antipsychotics with a lower H1 receptor affinity and weight gain liability such as ziprasidone or aripiprazole (reviewed in [127,130] ). Additionally, besides switching medication, pharmacologiccal treatments may also be considered to reduce SGA-induced weight gain such as the co-treatment of betahistine and reboxetine.…”

Section: Discussionmentioning

confidence: 99%

The Role of Hypothalamic H1 Receptor Antagonism in Antipsychotic-Induced Weight Gain

Deng

Huang

2013

CNS Drugs

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Treatment with second generation antipsychotics (SGAs), notably olanzapine and clozapine, causes severe obesity side effects. Antagonism of histamine H1 receptors has been identified as a main cause of SGAinduced obesity, but the molecular mechanisms associated with this antagonism in different stages of SGAinduced weight gain remain unclear. This review aims to explore the potential role of hypothalamic histamine H1 receptors in different stages of SGA-induced weight gain/obesity and the molecular pathways related to SGA-induced antagonism of these receptors. Initial data have demonstrated the importance of hypothalamic H1 receptors in both short-and long-term SGA-induced obesity. Blocking hypothalamic H1 receptors by SGAs activates AMP-activated protein kinase (AMPK), a well-known feeding regulator. During short-term treatment, hypothalamic H1 receptor antagonism by SGAs may activate the AMPK-carnitine palmitoyltransferase 1 signaling to rapidly increase caloric intake and result in weight gain. During long-term SGA treatment, hypothalamic H1 receptor antagonism can reduce thermogenesis, possibly by inhibiting the sympathetic outflows to the brainstem rostral raphe pallidus and rostral ventrolateral medulla, therefore decreasing brown adipose tissue thermogenesis. Additionally, blocking of hypothalamic H1 receptors by SGAs may also contribute to fat accumulation by decreasing lipolysis but increasing lipogenesis in white adipose tissue. In summary, antagonism of hypothalamic H1 receptors by SGAs may time-dependently affect the hypothalamus-brainstem circuits to cause weight gain by stimulating appetite and fat accumulation but reducing energy expenditure. The H1 receptor and its downstream signaling molecules could be valuable targets for the design of new compounds for treating SGA-induced weight gain/obesity.

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“…Sun et al concluded that subnormal WBC counts (<3.9 × 10 9 cells/L), which rather exclude even lowgrade systemic inflammation, are related to the lower prevalence of metabolic syndrome and the lowest incidence of metabolic syndrome during a 5-year follow-up period among healthy population than WBC counts within reference range [9]. Metabolic alterations are particularly common in patients treated with antipsychotics [10]. In this group around 50% suffer from metabolic disorders, which significantly reduces the lifespan and life quality.…”

Section: Introductionmentioning

confidence: 99%

Comparison of white blood cells parameters in patients with acute schizophrenia, unipolar depression and bipolar disorder

Wysokiński¹,

Margulska²

2017

Arch Psych Psych

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SummaryObjective: We compared white blood cells parameters (total white blood cells (WBC), lymphocytes count (LYMPH#) and percentage (LYMPH%), monocytes count (MONO) and percentage (MONO%), basophils count (BASO#) and percentage (BASO%), eosinophils count (EO#) and percentage (EO%), neutrophils count (NEUT#) and percentage (NEUT%)) in patients with schizophrenia (SHZ), unipolar depression (UD) and bipolar disorder (BIP): bipolar depression (BD) and mania (BM).Methods: This was a retrospective, cross-sectional, naturalistic study of 2381 patients (SHZ n=1244; UD n=794; BIP n=343, BD n=259, BM n=84). WBC as well as differential leukocytes count were measured using automated hematology analyzer.Results: There were significant differences between study groups (WBC, p=0.02; LYMPH# p=0.03; LYMPH% p=0.008; EO% p <0.001). Age and sex affected various white blood cells parameters.Conclusions: There are differences in white blood cells between study groups. Highest WBC was in the schizophrenia and bipolar mania groups, while patients with BM had lowest LYMPH%. Highest frequency of below or above normal WBC was found in patients with BM.

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Clinical monitoring and management of the metabolic syndrome in patients receiving atypical antipsychotic medications

Cited by 72 publications

References 95 publications

The protective effect of thymoquinone over olanzapine-induced side effects in liver, and metabolic side effects

The protective effect of thymoquinone over olanzapine-induced side effects in liver, and metabolic side effects

The Role of Hypothalamic H1 Receptor Antagonism in Antipsychotic-Induced Weight Gain

Comparison of white blood cells parameters in patients with acute schizophrenia, unipolar depression and bipolar disorder

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