Careful Antipsychotic Drug Monitoring Urged

Drugs Used to Treat Mental Illnesses May Increase Heart Disease Risks

Reviewed by Brunilda Nazario, MD on January 27, 2004
From the WebMD Archives

Jan. 27, 2004 -- People who take antipsychotic drugs to treat a wide range of mental illnesses may suffer from potentially rapid weight gain that could put them at risk for diabetes, high cholesterol, and heart disease.

Researchers say use of these drugs, known as second-generation antipsychotics, has soared in recent years for the treatment of a variety of mental illnesses, such as schizophrenia, bipolar disorder, major depression, autism, and dementia.

For those who respond well to these drugs, they can mean the difference between leading a fulfilling life and being severely disabled. But researchers say use of these drugs has also been associated with dramatic weight gain, diabetes, and unhealthy cholesterol levels.

Because of those risks, experts are now calling for more careful screening and monitoring of the use of antipsychotic drugs, including:

A joint panel of the American Diabetes Association, American Psychiatric Association, American Association of Clinical Endocrinologists, and the North American Association issued the recommendations for the Study of Obesity. The findings appear in the February issue of Diabetes Care.

New Antipsychotic Guidelines Issued

The panel says, "there is considerable evidence" that treatment with antipsychotic drugs can cause rapid weight gain, and most of the weight gained is fat. Research also suggests that use of antipsychotic drugs can lead to the development of pre-diabetes, diabetes, and elevated cholesterol levels.

In some cases, researchers say use of these drugs has also been linked to a life-threatening condition known as diabetic ketoacidosis.

In light of those risks, the panel recommends that doctors prescribing antipsychotic drugs pre-screen their patients for heart disease risk factors, including:

The recommendations also call for frequent monitoring of these risk factors among people receiving antipsychotic drug therapy. The panel says antipsychotic drug users should be referred to specialists if they experience problems with significant weight gain, diabetes, or other heart disease risk factors.


Finally, the guidelines advise that overweight or obese people prescribed an antipsychotic drug should also receive counseling about proper nutrition and physical activity levels.

Researchers say the risks associated with various antipsychotic drugs vary, and more study is needed to better define those risks.

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SOURCE: American Diabetes Association, Diabetes Care, February 2004; vol 27: pp 596-601.

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