Metabolic syndrome represents a cluster of interrelated metabolic dysfunctions which are risk factors for the development of diabetes and cardiovascular disease. Results of clinical studies suggest significant effects of certain psychotropic medications on weight gain and manifestation of type II diabetes. The psychoactive drugs may influence weight gain through increased food consumption and disruption of satiety signaling system. Some psychoactive medications cause weight increase, insulin resistance, dyslipidemia, impairment glucose tolerance/ type II diabetes and hypertension. Dyslipidemia and increase of insulin resistance can be collateral or a direct consequence of psychoactive drug actions. The authors have reviewed accessible literature throughout electronic databases ten years aback in order to estimate prevalence of metabolic syndrome in the mentally ill, give an overview of accomplishments in researching pathophysiology of metabolic syndrome and effects of psychotropic drugs on apparition and pathophysiological mechanisms in causing mentioned syndrome. Finally, the authors consolidated guidelines and references for prevention and treatment of patients with metabolic syndrome induced by psychotropic drugs.