Safety Concerns over Antipsychotic Medication Treatment

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Antipsychotic medications can be effective for some people, and in some people these medications are fairly well and tolerated treatments for mood and psychotic disorders. There seems to be concern with a number of antipsychotic medications being associated with weight gain, and for some, hyperglycemia and hyperlipidemia.

In the most recent issue of Biological Psychiatry, researchers discuss a variety of metabolic side effects and how it may contribute to the risk for diabetes, hypertension, and other medical disorders associated with heart disease. This is of a very large concern because there is a high level of cardiovascular mortality among the mentally ill compared to the general population.

Researchers are fully aware that differences exist between antipsychotics in their effect on clinical measures associated with cardiovascular risk, specifically weight, lipids and glucose. Systemic inflammation has recently appeared as an important marker of cardiovascular risk, but the effects of antipsychotics on inflammatory markers in the blood have not been studied until now.

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Using data from the multi-center CATIE (Clinical Antipsychotic Trials of Intervention Effectiveness) study, Jonathan Meyer and colleagues examined the impact of multiple antipsychotic therapies on changes in systemic inflammation. Their study has been funded by the National Institute of Mental Health,

In their recent findings, they discovered that antipsychotic medications, particularly olanzapine (Zyprexa®, Eli Lilly and Co.) and quetiapine (Seroquel®, AstraZeneca), increase the levels of inflammation markers. The markers implicated increased levels of C-reactive protein in particular are associated with increased risk for the development or progression of many illnesses including heart disease, and stroke.

"This analysis provides the most compelling evidence to date that differences in antipsychotic metabolic liability are also seen with markers of systemic inflammation," explained Dr. Meyer. "It also provides an impetus for monitoring cardiovascular risk markers in antipsychotic treated patients."

Dr. John Krystal, Editor of Biological Psychiatry said, "Doctors always try to balance the benefits and the risks associated with medications when making the decision to prescribe a particular medication to a particular patient. The more information that we have regarding the medical consequences of prescribing particular medications, the better the prescribing decisions can be."

Although this report does not provide any direct evidence linking the antipsychotic medications to these disorders, he added that "it is helpful to know that antipsychotic medications may contribute to inflammatory processes in the body and that these medications differ somewhat in producing this effect." More research into the safety of the use of antipsychotic medications is needed.

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