Metabolic status important to consider when choosing an antipsychotic drug

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An individual’s metabolic status is important to consider when choosing an antipsychotic drug. Weight gain, hyperglycemia, and dyslipidemia can occur when atypical antipsychotic drugs are prescribed to individuals without an accommodating metabolic status. Unfortunately, a recent retrospective study has revealed that less than 25% of patients are tested for glucose status or lipids by their physician prior to being prescribed antipsychotic drugs. According to Elaine H. Morrato, Dr.P.H., of the University of Colorado, 1,000 patients were tested for metabolic status six months before being prescribed an antipsychotic drug and their cholesterol levels, fasting blood glucose, and triglycerides were not found to be associated with drug choice. The following is an article from Medpage Today that reviews the findings of the study:

Atypical antipsychotic agents have been associated with metabolic changes such as weight gain, dyslipidemia, and hyperglycemia. Both the American Psychiatric Association and American Diabetes Association recommend routine metabolic screening and consideration of a patient’s metabolic status when selecting an atypical antipsychotic, the authors noted in a poster presentation at American Psychiatric Association meeting.

Yet physicians report that fewer than 25% of patients are screened for lipids or glucose status prior to being started on a drug, and even when patients are screened for metabolic risk factors, their physicians don’t always take the information into consideration when planning treatment with an antipsychotic agent, the investigators wrote.

The findings are emblematic of the failure of modern medicine to fully integrate the treatment of the mind with the treatment of the body, commented Thomas Wise, M.D., chairman of psychiatry at Inova Fairfax Hospital in Fairfax, Va., who was not involved in the study.

“In order to have the proper treatment, one cannot partition mind from body,” he said. “In addition to a system that doesn’t work, we have completely partitioned psychiatric care from medical care. It may be an overstatement or hyperbole, but somebody’s going to have to prove to me that it’s not true.”


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