Atypical Antipsychotics and Metabolic Syndrome: From Molecular Mechanisms to Clinical Differences.
Level 5 - mechanism / opinion, no new human data
Narrative review of mechanisms and comparative clinical risks with no primary data or systematic search
PubMed 33800403 · doi:10.3390/ph14030238
What was done
Narrative review examining the molecular mechanisms and comparative clinical profiles of metabolic syndrome caused by atypical antipsychotics in patients with psychotic disorders. The authors review drug actions on hypothalamic receptors, AMPK activity, sympathetic outflow, and peripheral metabolic organs including the liver, pancreatic beta-cells, adipose tissue, and skeletal muscle.
What was found
The abstract reports no numerical values. Qualitatively, it notes that metabolic disturbances can precede weight gain. Olanzapine and clozapine are associated with the highest risk of metabolic syndrome, quetiapine, risperidone, asenapine, and amisulpride carry moderate risk, and ziprasidone, lurasidone, and aripiprazole have more favorable metabolic profiles. Higher clinical efficacy appeared correlated with greater metabolic risk. Multidisciplinary psychoeducation, therapeutic drug monitoring, and pharmacological options are proposed.
Why it matters
Antipsychotic-induced metabolic syndrome reduces life expectancy and impairs treatment adherence. Delineating relative metabolic risk profiles assists clinicians in balancing therapeutic efficacy against cardiometabolic morbidity.
Limits
This is an unsystematic narrative review rather than a systematic review; no search criteria, study selection methods, or study counts are provided. The abstract gives no quantitative effect estimates or statistical comparisons.
Cited by
- context Atypical antipsychotics with the suffix '-apine' promote weight gain, likely mediated by hypothalamic insulin resistance that reduces satiety signaling.