Effects of statin therapies on individuals taking antipsychotics: a systematic review

Abstract

Patients taking antipsychotics to treat severe mental illness may develop adverse effects such as dyslipidaemia. We aimed to provide an update to a previous systematic review showing statin therapy lowering lipid levels in individuals taking antipsychotics, while further identifying any safety concerns or changes in BMI or blood pressure. In August 2022, we searched MEDLINE, Embase, PsycINFO, PubMed and Cochrane Central Register of Controlled Trials for studies on the effects of statins on lipid profile measures for individuals with severe mental illness taking first- or second-generation antipsychotic medications. Data extraction was performed in a masked duplicate fashion. On the basis of article type, the risk of bias in each study was assessed using ROBINS-I or RoB-2. The GRADE criteria were used for certainty assessment. Our initial search returned 396 articles, of which 6 were included in our analysis. Five of them (83.3%) identified a significant change between baseline and posttreatment lipids. Of the articles recording blood pressure, BMI or weight and significant safety concerns, no significant changes were found. The certainty assessment for this systematic review was rated as moderate. A meta-analysis was not performed. We found that studies continue to demonstrate the use of statin therapy in dyslipidaemia prevention and treatment and, in relation, decrease cardiovascular disease risk through significantly reduced LDL-C levels. Patients at risk of developing dyslipidaemias secondary to antipsychotic treatment should be considered for lipid-lowering therapy with a statin. The limited number of studies included and their heterogeneity demonstrate areas for improvement for future research.

The Potential Role of the Ketogenic Diet in Serious Mental Illness: Current Evidence, Safety, and Practical Advice

“…The potential side effects related to some medications and multimorbidity should be considered when planning the diet. The KD is high in fat, so lipid disturbances could occur, especially in patients receiving atypical antipsychotics [144][145][146]. Ensuring a healthy dietary fatty acid profile (mono-and polyunsaturated fatty acids, while avoiding saturated and transunsaturated fatty acids) and cooking techniques (cooking, grilling, and baking instead of frying) minimizes the risk of hypercholesterolemia.…”