Abnormalities of glucose metabolism associated with atypical antipsychotic drugs

J Clin Psychiatry. 2004;65 Suppl 18:36-46.

Abstract

The introduction of atypical antipsychotic drugs has provided a clear benefit for many schizophrenia patients, with less risk for the extrapyramidal side effects associated with conventional antipsychotics. However, some antipsychotics are associated with an increased risk of adverse metabolic outcomes, including weight gain, dyslipidemia, and hyperglycemia. Increases in adiposity and disturbances in glucose and lipid metabolism represent a serious health risk in a patient that may be predisposed to these metabolic conditions. The increased risk for diabetes with certain antipsychotics may be associated with the risk of treatment-induced weight gain. However, other mechanisms, including effects on central neurotransmitters and direct effects on glucose metabolism, may contribute to the development of disordered glucose metabolism. The purpose of this article is to review the association between antipsychotic medications and obesity, insulin resistance, and diabetes, including the mechanisms through which these changes might be effected.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / pharmacokinetics
  • Antipsychotic Agents / therapeutic use
  • Blood Glucose / drug effects
  • Blood Glucose / metabolism
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / chemically induced
  • Glucose / metabolism*
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / chemically induced
  • Hyperlipidemias / blood
  • Hyperlipidemias / chemically induced
  • Insulin Resistance
  • Metabolic Syndrome / blood
  • Metabolic Syndrome / chemically induced
  • Monosaccharide Transport Proteins / drug effects
  • Monosaccharide Transport Proteins / metabolism
  • Obesity / blood
  • Obesity / chemically induced
  • Receptors, Adrenergic / drug effects
  • Receptors, Adrenergic / metabolism
  • Receptors, Histamine / drug effects
  • Receptors, Histamine / metabolism
  • Receptors, Serotonin / drug effects
  • Receptors, Serotonin / metabolism
  • Risk Factors
  • Schizophrenia / blood
  • Schizophrenia / drug therapy*
  • Schizophrenia / metabolism
  • Weight Gain / drug effects

Substances

  • Antipsychotic Agents
  • Blood Glucose
  • Monosaccharide Transport Proteins
  • Receptors, Adrenergic
  • Receptors, Histamine
  • Receptors, Serotonin
  • Glucose