2005
DOI: 10.1517/14740338.4.5.849
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The safety and tolerability of atypical antipsychotics in bipolar disorder

Abstract: Atypical antipsychotics (aAPs), have become a first-line treatment option, both in schizophrenia and bipolar disorders. Almost all aAPs now have proven efficacy in acute mania, some also in bipolar depression and in maintenance treatment. This provides reliable data on their safety and tolerability in this particular group of patients. This review focuses on the safety and tolerability of aAPs in the treatment of bipolar disorders. Both tolerability, for example, extrapyramidal symptoms, and safety issues, for… Show more

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Cited by 18 publications
(13 citation statements)
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“…The typical clinical path toward diabetes is associated with increased adiposity and subsequent changes in insulin sensitivity; however, the rapid onset of diabetes associated with SGA administration, and the disappearance of hyperglycemia after discontinuation in patients suggests that the development of diabetes in patients on SGAs may be an acute drug-related effect (Rettenbacher et al, 2007). There is evidence that OLZ has direct effects on glucose regulation, possibly leading to hyperinsulinemia, hyperglycemia, and insulin resistance (Baptista et al, 2002;Graham et al, 2005;Melkersson and Hulting, 2001;Seemuller et al, 2005). Of note, recent experiments show that SGAs may impair both the insulinresponsive glucose transport system, as well as lipolysis in adipocytes (Vestri et al, 2007), demonstrating that antipsychotic drugs may differentially affect insulin action and metabolism through direct cellular effects in adipocytes.…”
Section: Discussionmentioning
confidence: 99%
“…The typical clinical path toward diabetes is associated with increased adiposity and subsequent changes in insulin sensitivity; however, the rapid onset of diabetes associated with SGA administration, and the disappearance of hyperglycemia after discontinuation in patients suggests that the development of diabetes in patients on SGAs may be an acute drug-related effect (Rettenbacher et al, 2007). There is evidence that OLZ has direct effects on glucose regulation, possibly leading to hyperinsulinemia, hyperglycemia, and insulin resistance (Baptista et al, 2002;Graham et al, 2005;Melkersson and Hulting, 2001;Seemuller et al, 2005). Of note, recent experiments show that SGAs may impair both the insulinresponsive glucose transport system, as well as lipolysis in adipocytes (Vestri et al, 2007), demonstrating that antipsychotic drugs may differentially affect insulin action and metabolism through direct cellular effects in adipocytes.…”
Section: Discussionmentioning
confidence: 99%
“…This may not be too surprising, as the atypical antipsychotics all display slightly different multireceptorial pharmacologies that probably account for these differences. The success of such a combination will furthermore depend on compoundspecific limitations known for all of the atypical antipsychotics, such as varying degrees of potential for inducing weight gain/metabolic disturbances, QTc prolongation, and elevation of prolactin [124].…”
Section: Sert Inhibition/antipsychotics and Sert Inhibition/ Mirtazepmentioning
confidence: 99%
“…As well, the availability of other treatments, including alternative atypical antipsychotics, without weight gain problems has exacerbated this issue (Seemuller et al 2005). Although the data in bipolar disorder with other atypical drugs are more limited, practitioners have tended to select more weight neutral compounds.…”
Section: A Renaissance Of Combination Psychotropics?mentioning
confidence: 99%