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Article August 15, 2005

Schizophrenia and Comorbid Metabolic Disorders

David C. Henderson, MD

J Clin Psychiatry 2005;66(suppl 6):11-20

Article Abstract

Comorbid metabolic disorders in patients with schizophrenia are underrecognized by many healthcare professionals and patients. That lack of awareness can contribute to serious morbidity and mortalityin patients with schizophrenia. Patients with schizophrenia may be at greater risk for metabolicdisorders such as insulin resistance, lipid abnormalities, and weight gain. In addition, although the useof atypical antipsychotics in the treatment of schizophrenia offers many positive benefits and may reducesome of the factors related to the morbidity and mortality of the disorder, these drugs appear tobe associated with varying degrees of comorbid metabolic disorders, such as metabolic syndrome, andmore serious consequences, such as cardiovascular disease. Recent consensus guidelines recommendthat metabolic risks be considered when initiating therapy with atypical antipsychotics. Thus, baselinescreening and routine monitoring of patient weight, fasting lipid profile, and fasting plasma glucoseare essential. In addition, optimal treatment for patients with schizophrenia and comorbid metabolicdisorders is best achieved when all parties involved with patient care (mental health and medical community,caregiver/family, and patient) communicate and work together. With proper awareness andcooperation on the part of the medical community, caregivers, and patients, the detrimental consequencesthat may result from the metabolic disorders addressed in this article can be at least partiallyoffset.