Article December 15, 2004

Dyslipidemia and Atypical Antipsychotic Drugs

Daniel E. Casey, MD

J Clin Psychiatry 2004;65(suppl 18):27-35

Article Abstract

Dyslipidemia is an increasing problem in most industrialized societies and is a risk factor for coronaryheart disease (CHD). Imbalances in individual lipid components, including total cholesterol,low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and serumtriglycerides, have each been shown to contribute to this increased risk. Certain psychiatric patientpopulations, such as those afflicted with schizophrenia, are of particular concern. Psychiatric patientswith schizophrenia are naturally at increased risk for dyslipidemia and obesity, in part due to poor dietand sedentary lifestyle, but these conditions can be exacerbated by some antipsychotic medications.Clozapine and olanzapine, for example, appear to be associated with hyperlipidemia, which may beassociated with changes in body weight. Other, newer antipsychotic agents may exhibit less liabilityfor weight gain and the development of dyslipidemia. This review is intended to briefly highlight theassociation between dyslipidemia and cardiovascular disease, the changes in serum lipids associatedwith some antipsychotic agents, and how these changes in serum lipids affect the monitoring ofschizophrenia patients.