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Metabolic and cardiovascular adverse effects associated with antipsychotic drugs

Marc De Hert1, Johan Detraux, Ruud van Winkel

  • 1University Psychiatric Center, Catholic University Leuven, Leuvensesteenweg 517, 3070 Kortenberg, Belgium. marc.de.hert@ uc-kortenberg.be

Nature Reviews. Endocrinology
|October 20, 2011
PubMed

Insights

Antipsychotic medications increase cardiovascular and metabolic risks, including type 2 diabetes. This review details these risks in adults and children, highlighting monitoring needs.

Area of Science:

  • Pharmacology
  • Cardiology
  • Endocrinology

Background:

  • Antipsychotic medications are linked to cardiovascular and metabolic issues like obesity, hyperglycemia, and dyslipidemia.
  • These adverse effects increase the risk of type 2 diabetes mellitus and cardiovascular disease.
  • Controversy exists regarding specific drug contributions and mechanisms, including QT interval prolongation.

Purpose of the Study:

  • To review the metabolic and cardiovascular risks associated with antipsychotic medications in adults and children.
  • To define healthcare disparities in monitoring these risks.
  • To provide recommendations for screening and monitoring patients on antipsychotic agents.

Main Methods:

  • Literature review of antipsychotic medications' cardiovascular and metabolic risks.
  • Analysis of pharmacological mechanisms and receptor-binding affinities.
  • Examination of healthcare disparities and monitoring practices.

Main Results:

  • Antipsychotic agents can cause glucose and lipid metabolism abnormalities through obesity-related and unrelated mechanisms.
  • Despite guidelines, many patients on antipsychotics are not screened for key metabolic and cardiac risk factors.
  • Increased use in pediatric populations raises concerns due to orexigenic effects.

Conclusions:

  • Antipsychotic medications pose significant metabolic and cardiovascular risks requiring careful management.
  • There are disparities in healthcare for monitoring these risks, particularly in vulnerable pediatric patients.
  • Enhanced screening and monitoring protocols are essential for patients taking antipsychotic medications.

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