Putting Metabolic Side Effects Into Perspective: Risks Versus Benefits of Atypical Antipsychotics
J Clin Psychiatry 2001;62(suppl 27):35-39
© Copyright 2014 Physicians Postgraduate Press, Inc.
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The lengthy list of the side effects and morbidity associated with the atypical antipsychotics might
make a patient with psychosis and his or her caregivers so concerned about the use of any of these
medications, particularly those associated with a higher risk of diabetes, weight gain, or increased
lipid levels, that they would prefer to avoid all of them. However, schizophrenia is associated with a
relatively high risk for several diseases, including diabetes, that is independent of the risks that are
linked to atypical antipsychotic use. Therefore, the clinician who might think, "Why use atypicals if
using the typical drugs will escape the problems of monitoring and all the associated effects of diabetes
and hyperglycemia?" needs to know that these problems cannot be avoided simply by choosing
typical antipsychotics. Clinicians, patients, and concerned family members must balance the significant
benefits of atypical antipsychotic treatment—improved cognition, reduced suicidality, and less
depression—against the risks of metabolic disturbances and select a course of treatment that includes
a realistic monitoring program.