De Hert Marc, van Eyck Dominique, De Nayer Andre
Universitair Centrum Sint-Jozef, Catholic University Louvain, Leuvensesteenweg 517, 3070 Kortenberg, Belgium.
Int Clin Psychopharmacol. 2006 Mar;21 Suppl 2:S11-5. doi: 10.1097/01.yic.0000201496.23259.85.
Epidemiological studies have demonstrated a relevant increased risk of diabetes in schizophrenic patients who are treated with many atypical antipsychotics, irrespective of concomitant weight gain. Numerous case reports and some large retrospective cohort studies have documented an increased risk of diabetes with some second-generation antipsychotics (SGAs), leading different authors to identify patients on SGA as another high-risk group for diabetes in their review articles. An American consensus conference dealing with this problem has proposed much awaited guidelines for the monitoring of patients on SGA and recommended acquiring additional data, especially from large-scale prospective studies. A more recent Belgian consensus on the screening and management of antipsychotic-related metabolic disturbances has proposed a more stringent approach. Here, we will cover the current diagnosis of metabolic problems, and provide a review of antipsychotic-related metabolic problems (diabetes, lipid abnormalities and the metabolic syndrome), as well as guidelines for the screening and management of metabolic abnormalities in people treated with antipsychotic medication.
流行病学研究表明，使用多种非典型抗精神病药物治疗的精神分裂症患者患糖尿病的风险显著增加，且与体重增加无关。众多病例报告和一些大型回顾性队列研究记录了某些第二代抗精神病药物（SGA）会增加糖尿病风险，这使得不同作者在其综述文章中将使用SGA的患者确定为糖尿病的另一高危人群。一个处理该问题的美国共识会议提出了备受期待的SGA治疗患者监测指南，并建议获取更多数据，尤其是来自大规模前瞻性研究的数据。比利时最近一项关于抗精神病药物相关代谢紊乱筛查和管理的共识提出了更严格的方法。在此，我们将涵盖代谢问题的当前诊断，并对抗精神病药物相关代谢问题（糖尿病、脂质异常和代谢综合征）进行综述，以及对抗精神病药物治疗人群代谢异常的筛查和管理指南。
