A new warning states that antipsychotic drugs, including clozaril, risperdal, zyprexa, seroquel, geodon and abilify, can increase a person's risk for developing obesity, diabetes and high cholesterol. And more kids than you would think are taking these antipsychotic drugs for a variety of mental illnesses, including bipolar disorder, autism, and aggressive behavior. That doesn't mean that you should stop them though. Instead, you and your doctor should discuss the risk of developing these disorders vs. the benefits your child is having from the medications and monitor your child for complications.
Antipsychotic Drugs Raise Obesity, Diabetes and Heart Disease Risk
People who take antipsychotic drugs for the treatment of a variety of mental illnesses may be at increased risk for obesity, diabetes and high cholesterol – all of which can lead to heart disease. Because of this, a joint panel of the American Diabetes Association, American Psychiatric Association, American Association of Clinical Endocrinologists, and the North American Association for the Study of Obesity has issued a consensus statement asking doctors to carefully screen and monitor patients on these medications for signs of rapid weight gain or other problems that could lead to diabetes, obesity and heart disease and refer them to specialists if necessary.
The consensus statement, published in the February issue of Diabetes Care , outlines guidelines for doctors treating people with a class of drugs known as second-generation antipsychotics (SGAs). These drugs, the use of which has soared in recent years, are used to treat a variety of mental illnesses, including: schizophrenia spectrum disorders; bipolar disorder; dementia; psychotic depression; autism and developmental disorders; and, to a lesser extent, delirium; aggressive behavior; personality disorders; and posttraumatic stress disorder.
The panel concluded that “there is considerable evidence” that treatment with SGAs can lead to rapid weight gain and that most of the weight gained is fat. Studies also show an association between SGA use and the development of pre-diabetes, diabetes, and elevated blood lipid levels. In some cases, SGA use has also been associated with diabetic ketoacidosis (DKA), which can be life-threatening. While weight gain was associated with first-generation antipsychotics, data regarding other metabolic effects are not available.
The panel also concluded that the SGAs differ in their risk profiles and that some SGAs, such as clozapine and olanzapine, while effective treatment options, raise a greater risk of weight gain, diabetes and lipid disorders than others. The statement notes that “...Even for those medications associated with an increased risk of metabolic side effects, the benefits to specific patients could outweigh the potential risks.” Thus, while risks reviewed in this study should influence choice of medication, the need to balance benefits and a wide range of risks underscores the importance of tailoring treatments to individual patients.
Therefore, the panel recommended that doctors prescribing antipsychotic drugs first perform baseline screenings of:
The panel recommended frequent follow-up monitoring of any patient receiving SGA therapy, and concluded that people at greatest risk for these complications should be prescribed SGAs least likely to cause them.
The panel concluded that more research is needed to more clearly define the risks associated with SGAs. In the meantime, as with all drugs, the undesirable side effects associated with SGAs should be an important consideration.
Diabetes Care , published by the American Diabetes Association, is the leading peer-reviewed journal of clinical research into the nation’s fifth leading cause of death by disease. Diabetes also is a leading cause of heart disease and stroke, as well as the leading cause of adult blindness, kidney failure and non-traumatic amputations. For more information about diabetes, visit the American Diabetes Association Web site www.diabetes.org or call 1-800-DIABETES (1-800-342-2383).
The consensus development conference was supported in part by an educational grant from AstraZeneca, Bristol-Myers Squibb Co., Janssen Pharmaceutical Products, Eli Lilly and Co., and Pfizer Inc.
Antipsychotic Drugs Raise Obesity, Diabetes and Heart Disease Risk
People who take antipsychotic drugs for the treatment of a variety of mental illnesses may be at increased risk for obesity, diabetes and high cholesterol – all of which can lead to heart disease. Because of this, a joint panel of the American Diabetes Association, American Psychiatric Association, American Association of Clinical Endocrinologists, and the North American Association for the Study of Obesity has issued a consensus statement asking doctors to carefully screen and monitor patients on these medications for signs of rapid weight gain or other problems that could lead to diabetes, obesity and heart disease and refer them to specialists if necessary.
The consensus statement, published in the February issue of Diabetes Care , outlines guidelines for doctors treating people with a class of drugs known as second-generation antipsychotics (SGAs). These drugs, the use of which has soared in recent years, are used to treat a variety of mental illnesses, including: schizophrenia spectrum disorders; bipolar disorder; dementia; psychotic depression; autism and developmental disorders; and, to a lesser extent, delirium; aggressive behavior; personality disorders; and posttraumatic stress disorder.
The panel concluded that “there is considerable evidence” that treatment with SGAs can lead to rapid weight gain and that most of the weight gained is fat. Studies also show an association between SGA use and the development of pre-diabetes, diabetes, and elevated blood lipid levels. In some cases, SGA use has also been associated with diabetic ketoacidosis (DKA), which can be life-threatening. While weight gain was associated with first-generation antipsychotics, data regarding other metabolic effects are not available.
The panel also concluded that the SGAs differ in their risk profiles and that some SGAs, such as clozapine and olanzapine, while effective treatment options, raise a greater risk of weight gain, diabetes and lipid disorders than others. The statement notes that “...Even for those medications associated with an increased risk of metabolic side effects, the benefits to specific patients could outweigh the potential risks.” Thus, while risks reviewed in this study should influence choice of medication, the need to balance benefits and a wide range of risks underscores the importance of tailoring treatments to individual patients.
Therefore, the panel recommended that doctors prescribing antipsychotic drugs first perform baseline screenings of:
- Personal and family history of obesity, diabetes, dyslipidemia (cholesterol and triglyceride levels), blood pressure or cardiovascular disease;
- Weight and height;
- Waist circumference;
- Blood pressure;
- Fasting plasma glucose; and
- Fasting lipid profile.
The panel recommended frequent follow-up monitoring of any patient receiving SGA therapy, and concluded that people at greatest risk for these complications should be prescribed SGAs least likely to cause them.
The panel concluded that more research is needed to more clearly define the risks associated with SGAs. In the meantime, as with all drugs, the undesirable side effects associated with SGAs should be an important consideration.
Diabetes Care , published by the American Diabetes Association, is the leading peer-reviewed journal of clinical research into the nation’s fifth leading cause of death by disease. Diabetes also is a leading cause of heart disease and stroke, as well as the leading cause of adult blindness, kidney failure and non-traumatic amputations. For more information about diabetes, visit the American Diabetes Association Web site www.diabetes.org or call 1-800-DIABETES (1-800-342-2383).
The consensus development conference was supported in part by an educational grant from AstraZeneca, Bristol-Myers Squibb Co., Janssen Pharmaceutical Products, Eli Lilly and Co., and Pfizer Inc.
I believe that everyone is right, to some extent. For example, for some patients, psychotherapy may be the only way. For others, maybe some other alternative treatments would be better. And it is argued that no treatment would be preferable for yet others. But for someone like my sister, who has had a problem with physical imbalances, such as hypothyroid since her premature birth, the meds and naturopathics, combined, seem to be essential, probably long-term. (Not that I’m saying that psych meds will work better for everyone with chemical imbalances). So everyone is different. You have to treat each one on a case by case basis.