Al-Zoairy Ramona, Ress Claudia, Tschoner Alexander, Kaser Susanne, Ebenbichler Christoph
Department of Internal Medicine I, Medical University Innsbruck, Innsbruck, Austria.
Curr Diabetes Rev. 2013 Sep;9(5):362-70. doi: 10.2174/15733998113099990067.
Psychotropic drugs, like antipsychotics and antidepressants, are often associated with metabolic side effects such as weight gain and an increased risk of the development of diabetes and an atherogenic lipid profile. These adverse effects not only bear a high cardiovascular risk and lead to higher morbidity and mortality, but are an additional burden to mentally ill patients and can be a decisive factor for the compliance and, consequently, the success of the therapy. Second generation antipsychotics (SGAs), in particular, clozapine and olanzapine, lead to significant weight gain and impair glucose metabolism. Despite the availability of newer SGAs, such as aripiprazole, which are considered to be less prone to cause metabolic side effects, olanzapine is still one of the most prescribed SGAs worldwide. Antidepressant drugs may also induce weight again and diabetes even though the literature is contradictory, probably due to different receptor affinities. This review aims to provide an overview of the metabolic side effects caused by commonly used psychotropic drugs and give insight into underlying mechanisms.
精神药物，如抗精神病药和抗抑郁药，通常与代谢副作用相关，如体重增加、患糖尿病风险增加以及致动脉粥样硬化的血脂谱。这些不良反应不仅带来高心血管风险，导致更高的发病率和死亡率，而且给精神病患者带来额外负担，并且可能是治疗依从性以及最终治疗成功与否的决定性因素。特别是第二代抗精神病药（SGA），如氯氮平和奥氮平，会导致显著体重增加并损害葡萄糖代谢。尽管有新型SGA，如阿立哌唑，被认为较少引发代谢副作用，但奥氮平仍是全球处方量最大的SGA之一。抗抑郁药也可能导致体重增加和糖尿病，尽管文献观点不一，这可能是由于不同的受体亲和力所致。本综述旨在概述常用精神药物引起的代谢副作用，并深入探讨其潜在机制。
