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Neuroleptic Metabolic Syndrome: The New NMS

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95 papers 100 to 500 followers Weighing in on the role of cardiometabolic effects of medications in psychiatric patients. Keywords: hypertension, diabetes mellitus, obesity, metabolic syndrome
By Edwin Kim Resident Physician, Aspiring Addiction Psychiatrist
Anto P Rajkumar, Henriette Thisted Horsdal, Theresa Wimberley, Dan Cohen, Ole Mors, Anders D Børglum, Christiane Gasse
OBJECTIVE: Diabetes mellitus contributes to excessive cardiovascular deaths and reduced life expectancy in schizophrenia. This population-based cohort study investigated the endogenous risk for diabetes in antipsychotic-naive schizophrenia and evaluated the risks added by starting antipsychotic treatment in people with schizophrenia. METHOD: The study followed all people born in Denmark on or after Jan. 1, 1977, until Jan. 1, 2013 (N=2,736,510). The Danish Psychiatric Central Research Register ascertained schizophrenia diagnoses...
January 20, 2017: American Journal of Psychiatry
Jason R Tatreau, Suzanne Harris, Brian Sheitman, Beat D Steiner
Background: Reverse colocation care models reduce lifestyle risk factors, emergency department visits, and readmissions. Persons with serious mental illness have higher than average rates of cardiovascular disease-related morbidity and mortality, with second-generation antipsychotics (SGAs) conferring added related risks. Little is written about reverse colocated medical care (RCL) in inpatient psychiatric settings. The objective of this study was to identify associations between screening, diagnosis, and treatment of chronic medical comorbidities and mode of medical care for patients discharged from 2 inpatient psychiatric units on SGAs...
December 22, 2016: Primary Care Companion to CNS Disorders
Desheng Zhai, Taizhen Cui, Yahui Xu, Yihang Feng, Xin Wang, Yuxin Yang, Songji Li, Dushuang Zhou, Gaopan Dong, Ying Zhao, Yunlei Yang, Ruiling Zhang
OBJECTIVE: It is well established that schizophrenia patients have high cardiovascular morbidity and mortality. However, the underlying risk factors in the earliest stages of both schizophrenia illness and antipsychotics treatment are less clear. This study aimed to characterize the metabolic features of those patients. METHODS: We performed a retrospective cohort study in a naturalistic setting, which included antipsychotic-naïve, first-episode schizophrenia (FES) inpatients with the baseline metabolic measurements and changes following a short term treatment with antipsychotic drugs...
January 2017: Schizophrenia Research
Evdokia Anagnostou, Michael G Aman, Benjamin L Handen, Kevin B Sanders, Amy Shui, Jill A Hollway, Jessica Brian, L Eugene Arnold, Lucia Capano, Jessica A Hellings, Eric Butter, Deepali Mankad, Rameshwari Tumuluru, Jessica Kettel, Cassandra R Newsom, Stasia Hadjiyannakis, Naomi Peleg, Dina Odrobina, Sarah McAuliffe-Bellin, Pearl Zakroysky, Sarah Marler, Alexis Wagner, Taylor Wong, Eric A Macklin, Jeremy Veenstra-VanderWeele
IMPORTANCE: Atypical antipsychotic medications are indicated for the treatment of irritability and agitation symptoms in children with autism spectrum disorder (ASD). Unfortunately, these medications are associated with weight gain and metabolic complications that are especially troubling in children and with long-term use. OBJECTIVE: To evaluate the efficacy of metformin for weight gain associated with atypical antipsychotic medications in children and adolescents with ASD (defined in the protocol as DSM-IV diagnosis of autistic disorder, Asperger disorder, or pervasive developmental disorder not otherwise specified), aged 6 to 17 years...
September 1, 2016: JAMA Psychiatry
Yuya Mizuno, Takefumi Suzuki, Atsuo Nakagawa, Kazunari Yoshida, Masaru Mimura, Walter Wolfgang Fleischhacker, Hiroyuki Uchida
BACKGROUND: Antipsychotic-induced metabolic adversities are often difficult to manage. Using concomitant medications to counteract these adversities may be a rational option. OBJECTIVE: To systematically determine the effectiveness of medications to counteract antipsychotic-induced metabolic adversities in patients with schizophrenia. DATA SOURCES: Published articles until November 2013 were searched using 5 electronic databases. Clinical trial registries were searched for unpublished trials...
November 2014: Schizophrenia Bulletin
Wei Zheng, Xian-Bin Li, Yi-Lang Tang, Ying-Qiang Xiang, Chuan-Yue Wang, Jose de Leon
This meta-analysis examined the effectiveness and safety of metformin to prevent or treat weight gain and metabolic abnormalities associated with antipsychotic drugs. We systematically searched in both English- and Chinese-language databases for metformin randomized controlled clinical trials (RCTs) using placebo in patients taking antipsychotics. Twenty-one RCTs (11 published in English and 10 in Chinese) involving 1547 subjects (778 on metformin, 769 on placebo) were included in this meta-analysis. Metformin was significantly superior to placebo (standard mean differences, -0...
October 2015: Journal of Clinical Psychopharmacology
Stephen J Cooper, Gavin P Reynolds, Tre Barnes, E England, P M Haddad, A Heald, Rig Holt, A Lingford-Hughes, D Osborn, O McGowan, M X Patel, C Paton, P Reid, D Shiers, J Smith
Excess deaths from cardiovascular disease are a major contributor to the significant reduction in life expectancy experienced by people with schizophrenia. Important risk factors in this are smoking, alcohol misuse, excessive weight gain and diabetes. Weight gain also reinforces service users' negative views of themselves and is a factor in poor adherence with treatment. Monitoring of relevant physical health risk factors is frequently inadequate, as is provision of interventions to modify these. These guidelines review issues surrounding monitoring of physical health risk factors and make recommendations about an appropriate approach...
August 2016: Journal of Psychopharmacology
Jian-Ping Zhang, Todd Lencz, Ryan X Zhang, Masahiro Nitta, Lawrence Maayan, Majnu John, Delbert G Robinson, W Wolfgang Fleischhacker, Rene S Kahn, Roel A Ophoff, John M Kane, Anil K Malhotra, Christoph U Correll
Although weight gain is a serious but variable adverse effect of antipsychotics that has genetic underpinnings, a comprehensive meta-analysis of pharmacogenetics of antipsychotic-related weight gain is missing. In this review, random effects meta-analyses were conducted for dominant and recessive models on associations of specific single nucleotide polymorphisms (SNP) with prospectively assessed antipsychotic-related weight or body mass index (BMI) changes (primary outcome), or categorical increases in weight or BMI (≥7%; secondary outcome)...
November 2016: Schizophrenia Bulletin
Lawrence Scahill, Sangchoon Jeon, Susan J Boorin, Christopher J McDougle, Michael G Aman, James Dziura, James T McCracken, Sonia Caprio, L Eugene Arnold, Ginger Nicol, Yanhong Deng, Saankari A Challa, Benedetto Vitiello
OBJECTIVE: We examine weight gain and metabolic consequences of risperidone monotherapy in children with autism spectrum disorder (ASD). METHOD: This was a 24-week, multisite, randomized trial of risperidone only versus risperidone plus parent training in 124 children (mean age 6.9 ± 2.35 years; 105 boys and 19 girls) with ASD and serious behavioral problems. We monitored height, weight, waist circumference, and adverse effects during the trial. Fasting blood samples were obtained before treatment and at week 16...
May 2016: Journal of the American Academy of Child and Adolescent Psychiatry
Shitij Kapur, Tiago Reis Marques
No abstract text is available yet for this article.
February 2016: JAMA Psychiatry
M C Mauri, S Paletta, M Maffini, A Colasanti, F Dragogna, C Di Pace, A C Altamura
This review will concentrate on the clinical pharmacology, in particular pharmacodynamic data, related to atypical antipsychotics, clozapine, risperidone, paliperidone, olanzapine, que¬tiapine, amisulpride, ziprasidone, aripiprazole, asenapine, iloperidone, lurasidone and cariprazine. A summary of their acute pharmacokinetics properties are also reported. Four new second-generation antipsychotics are available: iloperidone, asenapine, lurasidone and in the next future cariprazine. Similar to ziprasidone and aripiprazole, these new agents are advisable for the lower propensity to give weight gain and metabolic abnormalities in comparison with older second-generation antipsychotics such as olanzapine or clozapine...
2014: EXCLI journal
Michelle A Worthington, Rif S El-Mallakh
No abstract text is available yet for this article.
April 2015: Journal of Clinical Psychopharmacology
Kari M Ersland, Silje Skrede, Therese H Røst, Rolf K Berge, Vidar M Steen
Several antipsychotics have well-known adverse metabolic effects. Studies uncovering molecular mechanisms of such drugs in patients are challenging due to high dropout rates, previous use of antipsychotics and restricted availability of biological samples. Rat experiments, where previously unexposed animals are treated with antipsychotics, allow for direct comparison of different drugs, but have been hampered by the short half-life of antipsychotics in rodents. The use of long-acting formulations of antipsychotics could significantly increase the value of rodent models in the molecular characterization of therapeutic and adverse effects of these agents...
December 2015: Journal of Psychopharmacology
Davy Vancampfort, Alex J Mitchell, Marc De Hert, Pascal Sienaert, Michel Probst, Roselien Buys, Brendon Stubbs
OBJECTIVE: This systematic review and meta-analysis assessed the prevalence and predictors of type 2 diabetes mellitus (T2DM) in people with bipolar disorder. We also compared the prevalence of T2DM in people with bipolar disorder versus age- and gender-matched healthy controls. DATA SOURCES: PubMed, EMBASE, PsycARTICLES, and CINAHL were searched from inception till October 23, 2014 using the medical subject headings terms bipolar disorder AND diabetes OR glucose...
November 2015: Journal of Clinical Psychiatry
Stephen J Bartels, Sarah I Pratt, Kelly A Aschbrenner, Laura K Barre, John A Naslund, Rosemarie Wolfe, Haiyi Xie, Gregory J McHugo, Daniel E Jimenez, Ken Jue, James Feldman, Bruce L Bird
OBJECTIVE: Few studies targeting obesity in serious mental illness have reported clinically significant risk reduction, and none have been replicated in community settings or demonstrated sustained outcomes after intervention withdrawal. The authors sought to replicate positive health outcomes demonstrated in a previous randomized effectiveness study of the In SHAPE program across urban community mental health organizations serving an ethnically diverse population. METHOD: Persons with serious mental illness and a body mass index (BMI) >25 receiving services in three community mental health organizations were recruited and randomly assigned either to the 12-month In SHAPE program, which included membership in a public fitness club and weekly meetings with a health promotion coach, or to fitness club membership alone...
April 2015: American Journal of Psychiatry
Srinivasan Tirupati, Ling-Ern Chua
OBJECTIVE: People with schizophrenia and bipolar disorders suffer from increased rates of obesity and metabolic syndrome. Metabolic disorders add to the burden of disease and affect treatment and rehabilitation outcomes. This study aimed to study the prevalence of obesity and metabolic syndrome in people with chronic psychotic disorders in a psychiatric rehabilitation setting. METHOD: All patients in the psychiatry rehabilitation program were assessed for obesity and metabolic syndrome using the definition of International Diabetes Federation (2005) was conducted as part of clinical protocol recently introduced into practice...
July 2007: Australian and New Zealand Journal of Psychiatry
P Gardner-Sood, J Lally, S Smith, Z Atakan, K Ismail, K E Greenwood, A Keen, C O'Brien, O Onagbesan, C Fung, E Papanastasiou, J Eberhard, J Eberherd, A Patel, R Ohlsen, D Stahl, A David, D Hopkins, R M Murray, F Gaughran
BACKGROUND: The aims of the study were to determine the prevalence of cardiometabolic risk factors and establish the proportion of people with psychosis meeting criteria for the metabolic syndrome (MetS). The study also aimed to identify the key lifestyle behaviours associated with increased risk of the MetS and to investigate whether the MetS is associated with illness severity and degree of functional impairment. METHOD: Baseline data were collected as part of a large randomized controlled trial (IMPaCT RCT)...
2015: Psychological Medicine
Robert F Kushner, Donna H Ryan
IMPORTANCE: Even though one-third of US adults are obese, identification and treatment rates for obesity remain low. Clinician engagement is vital to provide guidance and assistance to patients who are overweight or obese to address the underlying cause of many chronic diseases. OBJECTIVES: To describe current best practices for assessment and lifestyle management of obesity and to demonstrate how the updated Guidelines (2013) for Managing Overweight and Obesity in Adults based on a systematic evidence review sponsored by the National Heart, Lung, and Blood Institute (NHLBI) can be applied to an individual patient...
September 3, 2014: JAMA: the Journal of the American Medical Association
David G Marrero, Yong Ma, Mary de Groot, Edward S Horton, David W Price, Elizabeth Barrett-Connor, Mercedes R Carnethon, William C Knowler
OBJECTIVE: To assess in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study whether diagnosis of diabetes predicted elevated depressive symptoms (DS) or use of antidepressant medicine (ADM) following diagnosis; whether diabetes status or duration had significant effect on DS or ADM use; and to determine the associations between A1C, fasting plasma glucose (FPG), normalization of FPG, and DS or ADM use after diagnosis. METHODS: Diabetes Prevention Program participants in three treatment arms (intensive life style, metformin, placebo) were assessed for diabetes, glucose control, ADM use, and DS, measured using the Beck Depression Inventory (BDI)...
April 2015: Psychosomatic Medicine
Robert Stanton, Trish Donohue, Michelle Garnon, Brenda Happell
PURPOSE: This study examines attendance at, and satisfaction with, a group exercise program in an inpatient mental health setting. DESIGN AND METHOD: Thirty-two inpatients completed discharge surveys to evaluate group activities. Data were analyzed for participation and satisfaction. FINDINGS: More inpatients (n = 16, 50%) rated exercise as "excellent" compared with all other activities. Nonattendance rates were lowest for cognitive behavioral therapy (n = 2, 6...
January 2016: Perspectives in Psychiatric Care
2015-03-13 14:08:59
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