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Lipid Metabolism Disturbances During Antipsychotic Treatment for Schizophrenia

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NeuroPsychopharmacotherapy

Abstract

Patients with schizophrenia experience increased morbidity and mortality and have an approximately 20% shorter lifespan. Patients with schizophrenia also have a relatively increased prevalence of cardiometabolic risk factors, such as obesity, type 2 diabetes, hypertension, hyperglycemia, and dyslipidemia. The odds ratio (OR) for metabolic syndrome in patients with chronic schizophrenia compared to the general population was 2.35. Although the individual differences of these metabolic disturbances have been observed, an understanding of the underlying mechanisms is still uncertain. A meta-analysis demonstrated that approximately 40% of patients with schizophrenia and related disorders have abnormalities in lipid metabolism. This chapter reviews the association between antipsychotics and dyslipidemia in patients with schizophrenia and the appropriate monitoring and interventions to address metabolic disorders in this population. Olanzapine use was associated with nearly a five-fold increase in the odds of developing hyperlipidemia compared with no antipsychotic exposure in database studies. In meta-analyses, total cholesterol level increased with quetiapine, olanzapine, and clozapine. Further prospective studies are necessary on the association between schizophrenia and lipid metabolism including various factors such as age, weight, gender, diet, exercise, and race that may affect lipid metabolism. In addition, regular monitoring is important in clinical settings.

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Authors and Affiliations

  1. Department of Community Psychiatric Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

    Shin Ono

  2. Department of Psychiatry, Niigata University Graduates School of Medicine and Dental Science, Niigata, Japan

    Toshiyuki Someya

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  1. Shin Ono
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  2. Toshiyuki Someya
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Correspondence to Shin Ono .

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Editors and Affiliations

  1. Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy, University Hospital Wuerzburg, Wuerzburg, Germany

    Peter Riederer

  2. Institute of Psychological Medicine (IPM), Soyen, Germany

    Gerd Laux

  3. Centre for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

  4. Center Translational Res Neurol Diseases, Dalian Med Uni Shanghai Inst Health Sc Center Translational Res Neurol Diseases, Dalian, China

    Weidong Le

  5. Würzburg, Germany

    Christian Riederer

Section Editor information

  1. Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy, Univsersity of Hospital Würzburg, Würzburg, Germany

    Peter Riederer

  2. Department of Psychiatry, University of South Denmark, Odense, Denmark

    Peter Riederer

  3. Center for Research Promotion and Support, Fujita Health University School of Medicine, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

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Ono, S., Someya, T. (2022). Lipid Metabolism Disturbances During Antipsychotic Treatment for Schizophrenia. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-030-62059-2_402

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