Effect of Antipsychotic Medications on Glucose and Lipid Levels

Abstract

Severe mental illnesses, such as schizophrenia and bipolar affective disorder, are associated with excess cardiovascular morbidity and mortality. Cardiovascular risk in psychiatric disorders is partly related to antipsychotic therapy, especially second-generation or atypical antipsychotics. Some antipsychotic medications are associated with proatherogenic conditions including insulin resistance and dyslipidemia. In particular, olanzapine and clozapine have been consistently demonstrated to promote insulin resistance and dyslipidemia. Ziprasidone and amisulpiride may be associated with more favorable metabolic effects. Many of the published data relating to metabolic effects of anti-psychotics originate from retrospective studies. However, prospective randomized-controlled data are emerging, and the latest evidence is described here.

Drug-Induced Dyslipidemia

“…Among the different antipsychotics, clozapine and olanzapine are associated with the highest risk for metabolic complications followed by resperidone and quetiapine, while ziprasidone and aripiprazole have the least risk [206,213].…”

Surgical treatment of morbid obesity among patients with bipolar disorder: a research agenda

“…[10][11][12][13][14][15] The medications used to treat BD, particularly atypical antipsychotics, are also potent contributors to weight gain, insulin resistance, and dyslipidemia. 16 In addition to having increased risk of obesity, patients with mental illness may be more likely to seek medical or surgical treatment for obesity. 17 found that employees with BD had total costs three times higher than employees without BD, including costs two to three times higher for endocrine, nutritional, and metabolic diseases; circulatory system disease; and immune-based disorders.…”

Improving Lifestyle Interventions for People With Serious Mental Illnesses: Qualitative Results from the STRIDE Study

“…Such interventions are helpful because they address access to and affordability of healthy foods, safe places to exercise, and education and skills that support attempts to lose weight and improve and maintain health. This type of approach may be particularly important for individuals with serious mental illnesses who are more likely to have less access to healthy foods (Drewnowski, 2012), limited autonomy over food choices when living in controlled environments (Lowndes, Angus, & Peter, 2013), poorer nutrition and sedentary lifestyles (Casagrande et al, 2011;Janney et al, 2013;Kilbourne et al, 2009), unhealthy social environments , psychiatric medications that cause weight gain (Chaggar, Shaw, & Williams, 2011;Newcomer, 2005Newcomer, , 2007, and mental health symptoms Pearsall, Hughes, Geddes, & Pelosi, 2014) and associated cognitive impairments (Vohringer et al, 2013) that may affect lifestyle change efforts.…”