Atypical antipsychotics: A review on the prevalence, monitoring, and management of their metabolic and cardiovascular side effects

Mental Health Clinician - Tập 6 Số 4 - Trang 178-184 - 2016
Joyce Wei Xin Chong1, Earl Hsien-Jie Tan1, Chia Eng Chong2, Yiwei Ng1, Ruki Wijesinghe3
1Pharmacist, Department of Pharmacy, Institute of Mental Health, Singapore
2Senior Pharmacist, Department of Pharmacy, Institute of Mental Health, Singapore
3(Corresponding author) Principal Clinical Pharmacist, Specialist Pharmacist in Advanced Pharmacotherapy (Psychiatry), Department of Pharmacy, Institute of Mental Health, Singapore, [email protected]

Tóm tắt

Abstract Introduction: Excessive weight gain, glucose intolerance, and dyslipidemia are well-known physical side effects of the metabolic syndrome commonly associated with atypical antipsychotic (AAP) treatment. We review these side effects of AAPs and their monitoring and management strategies. Methods: A literature search was conducted to identify articles published on the prevalence, monitoring, and management of cardiometabolic side effects of AAPs. Results: Comparative risk of AAPs on weight gain, hyperlipidemia, glucose intolerance, and QT interval corrected for heart rate prolongation varies across the AAPs currently available. Likewise, pharmacologic and nonpharmacologic options investigated for management of these side effects, and monitoring those at appropriate intervals, differ based on the clinical condition and risk factors identified. Discussion: Atypical antipsychotics in general have little difference among them in short-term efficacy; however, the prevalence of their physical side effects substantially distinguishes them. It is of importance that clinicians carefully select AAPs bearing in mind the presence of risk factors, initiating patients directly on AAPs with a low risk of cardiometabolic side effects, and monitoring and managing those side effects at appropriate intervals.

Từ khóa


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