Sections
Obesity, Metabolic Syndrome, and Diabetes Mellitus | Cigarette Smoking | HIV and Hepatitis Risks | Extrapyramidal Side Effects | Tardive Dyskinesia and Tardive Dystonia | Neuroleptic Malignant Syndrome | Hyperprolactinemia
Excerpt
Medication side effects, as well as lifestyle and disease factors,
place patients with schizophrenia at increased risk of developing
obesity and metabolic side effects, including glucose intolerance,
type 2 diabetes, diabetic ketoacidosis, and hyperlipidemia (Dixon et al. 2000; Meyer and Koro 2004; Wirshing et al. 2002, 2003). While clinically significant
weight gain occurs in a substantial proportion of patients receiving
an antipsychotic medication (Baptista 1999), a convincing
body of evidence indicates that certain atypical antipsychotics
cause more weight gain than other agents (Allison et al. 1999; Lieberman et al. 2005; Wirshing et al. 1999). A large
meta-analytic study of atypical and typical antipsychotics (Wirshing et al. 1999) found a mean weight gain of 9.8 lbs with clozapine, 9.1
lbs with olanzapine, and 4.6 lbs with risperidone, compared with
2.4 lbs with haloperidol, while the atypical antipsychotic ziprasidone
was associated with a less than 1-lb weight gain. Furthermore, the
CATIE study demonstrated a greater than 7% weight gain
from baseline in 30% of patients receiving olanzapine,
16% of those receiving quetiapine, 14% of those
receiving risperidone, 12% of those receiving perphenazine,
and 7% of those receiving ziprasidone (Lieberman et al. 2005).