Evidence of Switching Antipsychotic Therapy to Improve Metabolic Disturbances




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Atypical antipsychotic medications are often prescribed in place of conventional antipsychotics because these newer agents are associated with a low incidence of extrapyramidal symptoms (EPS). However, many of the atypical antipsychotics have adverse metabolic side effects such as substantial weight gain. Weight gain and other metabolic side effects associated with the atypical antipsychotics have led to as high an incidence of noncompliance in patients with schizophrenia as EPS did with the older drugs. Weight gain is also associated with an increase in risk for diabetes, cardiovascular disease, and dyslipidemia. It is possible to reverse some of the weight gain associated with atypical antipsychotics by switching medications. Switching a patient to an appropriate low-weight-gain antipsychotic can improve weight gain and other metabolic issues often without risking efficacy.

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J Clin Psychiatry 2007;68(5):e13