Antipsychotic medications and cardiometabolic risk – A review of current literature

Abstract

In the USA, 68% of adults and 31% of children are overweight or obese. Obesity doubles mortality rates and has significant associated medical costs with an average obese person spending $1500 or more per year. In addition, 10% of all adults and 23% of adults over 60 years have type 2 diabetes, with an average person spending $2257 or more per year. In 2009, 1 out of every 10 healthcare dollars was spent on type 2 diabetes, totalling $174 billion. People with serious and persistent mental illness die on average 25 years earlier than the general population. Cardiovascular disease is the primary cause of death in persons with mental illness and accounts for 60% of the increased mortality. Furthermore, 46.24% of individuals with cardiometabolic risk factors who are also on antipsychotic medications take high- to moderate-risk antipsychotics. The cluster of cardiometabolic syndrome includes: type 2 diabetes, hypertension, dyslipidemia, obesity and pre-existing cardiovascular disease. There are, however, modifiable risk factors including smoking cessation, diet change, physical activity, medical care and choice of antipsychotic medication (on which the physician has direct control). More information is therefore needed on various antipsychotic medications and their associated cardiometabolic risk factors in order to educate physicians. In this review article, we examined 10 articles on antipsychotic medications, and their effect on the 5 domains, including type 2 diabetes, hypertension, dyslipidemia, obesity and pre-existing cardiovascular disease. Overall, there was a clear trend, which found a significant difference in the associated risk factors amongst various antipsychotic medications.

Disclosure of interest

The authors have not supplied their declaration of competing interest.