Psychiatr. pro Praxi, 2009; 10(1): 22-25

Treatment with atypical antipsychotic drugs and their selection based on the spectrum of side effects

doc. MUDr. Radovan Přikryl Ph.D
Psychiatrická klinika LF MU a FN Brno

The introduction of second-generation antipsychotics into clinical practice has significantly improved the treatment of schizophrenia. When selecting a particular drug, however, its side-effect profile has to be considered in addition to affecting the targeted symptoms. The main side effects of first-generation antipsychotics include extrapyramidal side effects and hyperprolactinaemia which, along with obesity, hyperglycaemia, hyperlipidaemia, or cardiac complications, are considered to be the major risks associated with the treatment with second-generation antipsychotics. The physician must carefully assess the benefit as well as possible risks related to the side effects of the antipsychotic selected. The selection of a suitable antipsychotic must therefore be strictly individual, taking into account the benefit on the one hand and the possible risks on the other.

Keywords: Key words: antipsychotics, diabetes, dyslipidaemia, weight, metabolic syndrome, prolactin.

Published: February 1, 2009  Show citation

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Přikryl R. Treatment with atypical antipsychotic drugs and their selection based on the spectrum of side effects. Psychiatr. praxi. 2009;10(1):22-25.
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    References

    1. Kapur S, Seeman P. Does fast dissociation from the dopamine d(2) receptor explain the action of atypical antipsychotics? A new hypothesis. Am J Psychiatry. 2001; 158: 360-369. Go to original source... Go to PubMed...
    2. Wieck A, Haddad PM. Antipsychotic-induced hyperprolactinaemia in women: pathophysiology, severity and consequences. Selective literature review. Br J Psychiatry. 2003; 182: 199-204. Go to original source... Go to PubMed...
    3. David SR, Taylor CC, Kinon BJ, et al. The effects of olanzapine, risperidone, and haloperidol on plasma prolactin levels in patients with schizophrenia. Clin Ther. 2000; 22: 1085-1096. Go to original source... Go to PubMed...
    4. Kinon BJ, Gilmore JA, Liu H, et al. Prevalence of hyperprolactinemia in schizophrenic patients treated with conventional antipsychotic medications or risperidone. Psychoneuroendocrinology. 2003; 28(suppl 2): 55-68. Go to original source... Go to PubMed...
    5. Isomaa B. A major health hazard: the metabolic syndrome. Life Sci. 2003; 73: 2395-2411. Go to original source... Go to PubMed...
    6. Lindenmayer JP, Nathan AM, Smith RC. Hyperglycemia associated with the use of atypical antipsychotics. J Clin Psychiatry. 2001; 62(suppl 23): 30-38.
    7. Thonnard-Neumann E. Phenothiazines and diabetes in hospitalized women. Am J Psychiatry. 1956; 29: 827-828.
    8. Koller EA, Doraiswamy PM. Olanzapine-associated diabetes mellitus. Pharmacotherapy. 2002; 22: 841-852. Review. Go to original source... Go to PubMed...
    9. Newcomer JW, Haupt DW, Fucetola R, et al. Abnormalities in glucose regulation during antipsychotic treatment of schizophrenia. Arch Gen Psychiatry. 2002; 59: 337-345. Go to original source... Go to PubMed...
    10. Koro CE, Fedder DO, L'Italien GJ, et al. An assessment of the independent effects of olanzapine and risperidone exposure on the risk of hyperlipidemia in schizophrenic patients. Arch Gen Psychiatry. 2002; 59: 1021-1026. Go to original source... Go to PubMed...
    11. Henderson DC, Cagliero E, Gray C, et al. Clozapine, diabetes mellitus, weight gain, and lipid abnormalities: a five-year naturalistic study. Am J Psychiatry. 2000; 157: 975-981. Go to original source... Go to PubMed...
    12. Calle EE, Rodriguez C, Walker-Thurmond K, et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U. S. adults. N Engl J Med. 2003; 348: 1625-1638. Go to original source... Go to PubMed...
    13. Allison DB, Mackell JA, McDonnell DD. The impact of weight gain on quality of life among persons with schizophrenia. Psychiatr Serv. 2003; 54: 565-567. Go to original source... Go to PubMed...
    14. Baptista T, Kin NM, Beaulieu S, et al. Obesity and related metabolic abnormalities during antipsychotic drug administration: mechanisms, management and research perspectives. Pharmacopsychiatry. 2002; 35: 205-219. Go to original source... Go to PubMed...
    15. Hummer M, Kemmler G, Kurz M, et al. Weight gain induced by clozapine. Eur Neuropsychopharmacol. 1995; 5: 437-440. Go to original source... Go to PubMed...
    16. Bustillo JR, Buchanan RW, Irish D, et al. Differential effect of clozapine on weight: a controlled study. Am J Psychiatry. 1996; 153: 817-819. Go to original source... Go to PubMed...
    17. Allison DB, Mentore JL, Heo M, et al. Antipsychotic-induced weight gain: a comprehensive research synthesis. Am J Psychiatry. 1999; 156: 1686-1696. Go to original source... Go to PubMed...
    18. Atmaca M, Kuloglu M, Tezcan E, et al. Serum leptin and triglyceride levels in patients on treatment with atypical antipsychotics. J Clin Psychiatry. 2003; 64: 598-604. Go to original source... Go to PubMed...
    19. Meyer JM. A retrospective comparison of weight, lipid, and glucose changes between risperidone - and olanzapine-treated inpatients: metabolic outcomes after 1 year. J Clin Psychiatry. 2002; 63: 425-433. Go to original source... Go to PubMed...
    20. Meltzer HY, Davidson M, Glassman AH, et al. Assessing cardiovascular risks versus clinical benefits of atypical antipsychotic drug treatment. J Clin Psychiatry. 2002; 63(suppl 9): 25-29.

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