Department of Psychiatry, University of Naples SUN, Naples, Largo Madonna delle Grazie, 80138, Napoli, Italy.
Psychiatr Clin North Am. 2009 Dec;32(4):775-94. doi: 10.1016/j.psc.2009.08.003.
People with schizophrenia have an increased prevalence of overweight/obesity, type 2 diabetes mellitus, dyslipidemia, and metabolic syndrome, which increases the risk for cardiovascular diseases and mortality. Part of this increased risk is attributable to the use of antipsychotic medications, especially second-generation antipsychotics. Antipsychotic drugs differ in their potential to induce weight gain, with clozapine and olanzapine exhibiting the highest weight gain liability; evidence for differing effects of antipsychotics on glucose and lipid metabolism is less convincing. Individuals with schizophrenia may develop hyperprolactinemia, with or without clinical symptoms, after starting antipsychotic medications. This effect is particularly frequent with first-generation antipsychotics and with the second-generation antipsychotic risperidone and paliperidone. Psychiatrists should be aware of metabolic and endocrine side effects of antipsychotics and should make every effort to prevent or minimize them to improve the patients' compliance and quality of life.
精神分裂症患者超重/肥胖、2 型糖尿病、血脂异常和代谢综合征的患病率增加，这增加了心血管疾病和死亡率的风险。这种风险增加的部分原因是抗精神病药物的使用，尤其是第二代抗精神病药物。抗精神病药物在引起体重增加的潜力方面存在差异，氯氮平和奥氮平表现出最高的体重增加倾向；抗精神病药物对葡萄糖和脂质代谢影响的证据不太令人信服。精神分裂症患者在开始使用抗精神病药物后可能会出现高催乳素血症，无论是否有临床症状。这种影响在第一代抗精神病药物和第二代抗精神病药物利培酮和帕利哌酮中尤为常见。精神科医生应该意识到抗精神病药物的代谢和内分泌副作用，并尽一切努力预防或最小化这些副作用，以提高患者的依从性和生活质量。
