Metabolic syndrome with antipsychotics

Meyer, J. M., Nasrallah, H. A., McEvoy, J. P., Goff, D. C. et al. (2005). The clinical antipsychotic trials of intervention effectiveness trial clinical comparison of subgroups with and without metabolic syndrome. Schizophr. Res., 80, 9-18. 

Test for metabolic syndrome associated with antipsychotic treatment... 

McEvoy JP, Meyer JM, Goff DC, et al. Prevalence of the metabolic syndrome in patients with schizophrenia baseline results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III. Schizophr Res 2005 80 19-32. 

Meyer JM, Davis VG, Goff DC, et al. Change in metabolic syndrome parameters with antipsychotic treatment in the CATIE Schizophrenia trial prospective data from phase 1, Schizophr Res 2008 [Feb 5, Epub ahead of print],... 

Patients with bipolar disorder and schizophrenia who are treated with second-generation antipsychotic drugs had similar high rates of the metabolic syndrome in a retrospective comparison of different metabolic parameters [33 f. The prevalence of metabolic syndrome in a matched and randomly selected sample was 43% in bipolar disorder (n = 74) and 46% in schizophrenia (n = 111). 

Correll CU, Frederickson AM, Kane JM, Manu P. Equally increased risk for metabolic syndrome in patients with bipolar disorder and schizophrenia treated with second-generation antipsychotics. Bipolar Disord 2008 10(7) 788-97. 

Susceptibility factors A study of tumour necrosis factor-alpha (TNF-a) in 99 patients with bipolar depression found that treatment with olanzapine, quetiapine, risperidone, paliperidone or clozapine was associated with significantly greater TNF-a and a higher likelihood of metabolic syndrome [74FI TNF-a was greater in those with metabolic syndrome and there was a significant effect on the indirect relationship between antipsychotic treatment and elevated waist circumference. 

ARIPIPRAZOLE, HALOPERIDOL, CLOZAPINE, PIMOZIDE, RISPERIDONE, SERTINDOLE PROTEASE INHIBITORS Possibly T levels of antipsychotic Inhibition of CYP3A4- and/or CYP2D6-mediated metabolism Avoid co-administration of clozapine with ritonavir, and pimozide or sertindole with protease inhibitors. Use other antipsychotics with caution as 1 dose may be required with risperidone, watch closely for extrapyramidal side-effects and neuroepileptic malignant syndrome... 

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