Key result
Atypical antipsychotics vary in their risk of causing weight gain, hyperlipidemia, glucose intolerance, and QTc prolongation, requiring careful selection and monitoring based on patient risk factors.
Clinicians must carefully select atypical antipsychotics based on patient risk factors due to varying risks of cardiometabolic side effects like weight gain and QTc prolongation.
Requires risk-based atypical selection in cardiac patients; confirms variable metabolic/QTc effects but leaves optimal choices open.
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.
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Chong et al. (2016) conducted a review in Metabolic and cardiovascular side effects of atypical antipsychotics. Atypical antipsychotics was evaluated on Cardiometabolic side effects including weight gain, hyperlipidemia, glucose intolerance, and QTc prolongation. Atypical antipsychotics vary in their risk of causing weight gain, hyperlipidemia, glucose intolerance, and QTc prolongation, requiring careful selection and monitoring based on patient risk factors.
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