Cardiometabolic comorbidity in antipsychotic treated patients: need for systematic evaluation and treatment

Int J Psychiatry Clin Pract. 2013 Jun;17(2):125-30. doi: 10.3109/13651501.2013.779000. Epub 2013 May 13.

Abstract

Objective: The aim of the study was to determine the prevalence of cardiometabolic dysregulations and their somatic treatment regimens in a group of psychiatric patients treated with antipsychotics.

Methods: In a naturalistic cohort study, baseline cardiometabolic parameters were measured in 543 outpatients. After one year, a second assessment was performed in 220 patients out of the total sample. In addition, it was investigated whether in patients with somatic comorbidities adequate treatment was prescribed.

Results: In this cohort, about half of the patients fulfilled the criteria for metabolic syndrome. Only a limited number of patients, however, received pharmacologic treatment for individual risk factors: About 19% for hypercholesterolemia, 26% for hypertension, and 52% for diabetes. Non-treated patients were significantly younger than treated patients. Follow-up data show that the course of the cardiometabolic parameters can be dynamic.

Conclusions: Cardiometabolic risk factors are highly prevalent in psychiatric patients treated with antipsychotic drugs. Unfortunately, adequate treatment of cardiometabolic comorbidity in these relatively young patients is seriously hampered. Thus, specific guidelines for psychiatric patients have to be developed taking into account the high cardiovascular risk at a relatively young age and potential pharmacokinetic interactions between psychotropics and somatic compounds. Moreover, integration of psychiatric and physical health care systems for patients with mental disorders is urgently needed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Antipsychotic Agents / adverse effects*
  • Cardiovascular Diseases / chemically induced
  • Cardiovascular Diseases / drug therapy
  • Cardiovascular Diseases / epidemiology*
  • Cohort Studies
  • Comorbidity
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / epidemiology
  • Female
  • Humans
  • Hypercholesterolemia / drug therapy
  • Hypercholesterolemia / epidemiology
  • Hypertension / drug therapy
  • Hypertension / epidemiology
  • Male
  • Mental Disorders / drug therapy
  • Mental Disorders / epidemiology*
  • Metabolic Syndrome / chemically induced
  • Metabolic Syndrome / drug therapy
  • Metabolic Syndrome / epidemiology*
  • Netherlands / epidemiology
  • Prevalence
  • Psychotropic Drugs / therapeutic use
  • Risk Factors

Substances

  • Antipsychotic Agents
  • Psychotropic Drugs