Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-16T21:27:09.076Z Has data issue: false hasContentIssue false
  • English
  • Français

Treating the Mind and Body in Schizophrenia: Risks and Prevention

Published online by Cambridge University Press:  07 November 2014

Jonathan M. Meyer
Get access Rights & Permissions [Opens in a new window]

Abstract

Patients with schizophrenia have increased mortality due to higher rates of suicide. However, natural causes of death, such as cardiovascular disease, also contribute greatly to excess mortality. Significant sources of cardiovascular risk in this patient population include high smoking prevalence, inactive lifestyles, poor dietary habits, and the metabolic effects of atypical antipsychotics. These sources of risk interact with underrecognition of common medical conditions by mental health providers, limited access to primary care services, and undertreatment of health conditions in the general medical setting. For many patient with severe mental illness, the mental health setting represents the sole source of medical care, making the psychiatrist the de facto primary care provider for these individuals. With the recent focus on medical consequences of antipsychotic treatment, psychiatrist have an obligation to minimize these adverse effects by choosing antipsychotics with lower risk for metabolic side effects, and becoming familiar with the screening and management of common medical conditions.

Type
Academic Supplement
Information
CNS Spectrums , Volume 9 , Issue S11: Are All Atypical Antipsychotics Equal for the Treatment of Cognition and Affect in Schizophrenia? , October 2004 , pp. 25 - 33
Copyright
Copyright © Cambridge University Press 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285:2486–2497.CrossRefGoogle Scholar
2.American Diabetes Association; American Psychiatric Association; American Association of Clinical Endocrinologists; North American Association for the Study of Obesity. Consensus development conference on antipsychotic drugs and obesity and diabetes. J Clin Psychiatry. 2004;65:267–272.CrossRefGoogle Scholar
3.American Diabetes Association; American Psychiatric Association; American Association of Clinical Endocrinologists; North American Association for the Study of Obesity. Consensus development conference on antipsychotic drugs and obesity and diabetes. Diabetes Care. 2004;27:596–601.CrossRefGoogle Scholar
4.Nasrallah, HA, Mulvihill, T. Latrogenic disorders associated with conventional vs. atypical antipsychotics. Ann Clin Psychiatry. 2001;13(4):215–227.CrossRefGoogle Scholar
5.Leucht, S, et al.Relapse prevention in schizophrenia with new-generation antipsychotics: a systematic review and exploratory meta-analysis of randomized, controlled trials. Am J Psychiatry. 2003;160:1209–1222.CrossRefGoogle ScholarPubMed
6.Osby, U, Correia, N, Brandt, L, et al.Time trends in schizophrenia mortality in Stockholm County, Sweden. BMJ. 2000;321:483–484.CrossRefGoogle ScholarPubMed
7.Osby, U, Correia, N, Brandt, L, et al.Mortality and causes of death in schizophrenia in Stockholm county, Sweden. Schizophr Res. 2000;45:21–28.CrossRefGoogle ScholarPubMed
8.Cradock-O'Leary, J, Young, AS, Yano, EM, et al.Use of general medical services by VA patients with psychiatric disorders. Psychiatr Serv. 2002;53:874–878.CrossRefGoogle ScholarPubMed
9.Newman, SC, Bland, RC. Mortality in a cohort of patients with schizophrenia: a record linkage study. Can J Psychiatry. 1991;36:239–245.CrossRefGoogle Scholar
10.National Heart, Lung, and Blood Institute. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults-Executive Summary. National Institutes of Health. Available at: http://www.nhlbi.nih.gov/guidelines/obesity/ob_home.htm (includes charts for easy BMI calculations). Accessed June 27, 2004.Google Scholar
11.Lew, EA, Garfinkel, L. Variations in mortality by weight among 750,000 men and women. J Chron Dis. 1979;32:563–576.CrossRefGoogle Scholar
12.Addington, J, Mansley, C, Addington, D. Weight gain in first-episode psychosis. Can J Psychiatry. 2003;48:272–276.CrossRefGoogle ScholarPubMed
13.Allison, DB, Mentore, JL, Heo, M, et al.Antipsychotic-induced weight gain: a comprehensive research synthesis. Am J Psychiatry. 1999;156:1686–1696.CrossRefGoogle ScholarPubMed
14.Kulkarni, SK, Kaur, G. Pharmacodynamics of drug-induced weight gain. Drugs Today. 2001;37:559–571.CrossRefGoogle ScholarPubMed
15.Meyer, JM. Effects of atypical antipsychotics on weight and serum lipid levels. J Clin Psych. 2001;62(suppl 27):27–34.Google ScholarPubMed
16.Kroeze, WK, Hufeisen, SJ, Popadak, BA, et al.H1-histamine receptor affinity predicts short-term weight gain in typical and atypical antipsychotic drugs. Neuropsychopharmacology. 2003;28:519–526.CrossRefGoogle ScholarPubMed
17.Henderson, DC, Cagliero, E, Gray, C, et al.Clozapine, diabetes mellitus, weight gain, and lipid abnormalities: a five-year naturalistic study. Am J Psychiatry. 2000;157:975–981.CrossRefGoogle ScholarPubMed
18.Meyer, JM. A retrospective comparison of weight, lipid, and glucose changes between risperidone- and olanzapine-treated inpatients: metabolic outcomes after 1 year. J Clin Psychiatry. 2002;63:425–433.CrossRefGoogle ScholarPubMed
19.Weiden, PJ, Mackell, JA, McDonnell, DD. Obesity as a risk factor for antipsychotic noncompliance. Schizophr Res. 2004;66:51–57.CrossRefGoogle ScholarPubMed
20.American Diabetes Association Homepage. Available at: http://www.diabetes.org. Accessed June 29, 2004.Google Scholar
21.Koller, E, Doraiswamy, PM. Olanzapine-associated diabetes mellitus. Pharmacotherapy. 2002;22:841–852.CrossRefGoogle ScholarPubMed
22.Dixon, L, Weiden, P, Delahanty, J, et al.Prevalence and correlates of diabetes in national schizophrenia samples. Schizophr Bull. 2000;26:903–912.CrossRefGoogle ScholarPubMed
23.Ryan, MCM, Collins, P, Thakore, JH. Impaired fasting glucose tolerance in first-episode, drug-naïve patients with schizophrenia. Am J Psychiatry. 2003;160:284–289.CrossRefGoogle ScholarPubMed
24.Koller, E, Schneider, B, Bennett, K, et al.Clozapine-associated diabetes. Am J Med. 2001;111:716–723.CrossRefGoogle ScholarPubMed
25.Koller, EA, Cross, JT, Doraiswamy, PM, et al.Risperidone-associated diabetes mellitus: a pharmacovigilance study. Pharmacotherapy. 2003;23:735–744.CrossRefGoogle ScholarPubMed
26.Koller, EA. A survey of reports of quetiapine-associated hyperglycemia and diabetes mellitus. J Clin Psychiatry. 2004;65(6):857–863.CrossRefGoogle ScholarPubMed
27.Jin, H, Meyer, JM, Jeste, DV. Phenomenology of and risk factors for new-onset diabetes mellitus and diabetic ketoacidosis associated with atypical antipsychotics: an analysis of 45 published cases. Ann Clin Psychiatry. 2002;14:59–64.CrossRefGoogle ScholarPubMed
28.Wirshing, DA, Boyd, JA, Meng, LR, et al.The effects of novel antipsychotics on glucose and lipid levels. J Ciin Psychiatry. 2002;63:856–865.Google ScholarPubMed
29.Koro, CE, Fedder, DO, L'Italien, GJ, et al.An assessment of the independent effects of olanzapine and risperidone exposure on the risk of hyperlipidemia in schizophrenic patients. Arch Gen Psychiatry. 2002;59:1021–1026.CrossRefGoogle ScholarPubMed
30.Baymiller, SP, Ball, P, McMahon, RP, et al.Serum glucose and lipid changes during the course of clozapine treatment: the effect of concurrent betaadrenergic antagonist treatment. Schizophr Res. 2003;59:49–57.CrossRefGoogle ScholarPubMed
31.Meyer, JM. Novel antipsychotics and severe hyperlipidemia. J Clin Psychopharmocol. 2001;21:369–374.CrossRefGoogle ScholarPubMed
32.Atmaca, M, Kuloglu, M, Tezcan, E, et al.Serum leptin and triglyceride levels in patients on treatment with atypical antipsychotics. J Clin Psychiatry. 2003;64:598–604.CrossRefGoogle ScholarPubMed
33.Weiden, PJ, Daniel, DG, Simpson, G, et al.Improvement in indices of health status in outpatients with schizophrenia switched to ziprasidone. J Clin Psychopharmacol. 2003;23:595–600.CrossRefGoogle ScholarPubMed