Metabolic Abnormalities Linked to Antipsychotic Medication Therapy in Schizophrenia Patients

Abstract

For many years, people with schizophrenia have been shown to have serious metabolic problems, such as clinically substantial weight gain, hypertension, and disruption of glucose homeostasis. A significant treatment challenge for physicians is weight gain brought on by antipsychotics. In research studies, obesity and weight gain have been linked to a number of unfavorable outcomes, such as poor medication adherence, a higher risk of cardiovascular and cerebrovascular disorders, higher death rates, and a lower quality of life. Due to metabolic problems and obesity, patients with schizophrenia have a significantly lower life expectancy and higher death rates than people in the general population. While almost all antipsychotic medications are known to cause weight gain, the extent of this weight increase varies widely. Patients typically experience a rapid initial weight gain shortly after starting antipsychotics, and this trend continues over the long term. However, the exact mechanisms by which antipsychotics lead to metabolic issues and weight gain remain unclear. Despite the fact that there are protocols for identifying and tracking metabolic issues brought on by antipsychotics, these recommendations are not consistently applied in clinical practice. Various studies have also explored strategies to manage metabolic issues associated with antipsychotic use. However, due to the substantial clinical variation in both mental and metabolic symptoms throughout the course of the patient's illness, the findings in this area remain a subject of debate. In this narrative review, we offer a comprehensive examination of both classical and contemporary literature on metabolic concerns related to schizophrenia, focusing on the propensity of several antipsychotics to promote weight gain.