Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Metabolic Side Effects of Antipsychotics are Known, but Rarely Monitored

06.04.2005


Psychiatrists are doing a “modest” job of monitoring for weight gain, diabetes and other metabolic problems that may result from use of the newer antipsychotics for schizophrenia, researchers say.



Nearly all of the 258 members of the American Psychiatric Association in Georgia, Ohio and Iowa responding to a survey said they considered metabolic side effects serious or very serious, say researchers from the Medical College of Georgia, University of Iowa and Northcoast Behavioral Healthcare in Ohio.

However monitoring for these problems – including getting baseline data on personal and family health history as well as baseline and regular checks of height and body weight, waist circumference, blood pressure, fasting blood glucose and lipid levels – largely goes undone, researchers say of findings being presented during the 10th International Congress on Schizophrenia Research April 2-6 in Savannah, Ga.


“What we have found is that metabolic problems often associated with these drugs are a substantial concern and that clinicians are slowly beginning to change their practice to reflect that concern,” said Dr. Peter F. Buckley, lead investigator on the study and chair of the MCG Department of Psychiatry and Health Behavior.

Antipsychotics, such as clozapine and risperidone, which have come on the market in the last 10-15 years are touted for an improved ability to treat the delusions and hallucinations of schizophrenia without damaging muscle control, Dr. Buckley says. Parkinson-like tremors have been associated with older antipsychotics.

“These newer drugs are definitely more effective, they are just not without their own side effects,” Dr. Buckley says. “Some of those side effects fit unfortunately well with what’s happening in the world and America with rampant problems with obesity and type 2 diabetes.”

Groups such as the American Diabetes Association, the American Psychiatric Association and the American Association for Clinical Endocrinologists, have weighed in, making recommendations for evaluating and monitoring adverse metabolic effects. However, much like the current study, a 2004 phone survey of 300 psychiatrists commissioned by a pharmaceutical company showed while most were aware of metabolic consequences many had not incorporated recommendations for dealing with them into their practice.

“We still have a way to go,” says Dr. Buckley, who had just met with a young woman with schizophrenia already struggling with her weight. “I was telling her she needs a drug for her illness and that, unfortunately, there is also a risk that this drug will make her gain weight. She said she didn’t want to take it. I said you really don’t have a choice to take nothing. It’s awful having to present people with such difficult choices, especially when they’re already stressed dealing with mental problems,” he says.

Noncompliance has long been a problem for schizophrenics, because of movement problems associated with older drugs, and because many patients don’t realize they are ill, he says. The newer class of drugs work effectively to silence the over-communication in the brain that causes hallucinations, the hallmark of schizophrenia, by dampening the action of the neurotransmitter dopamine. Somehow in that process of altering brain chemistry, they also make people hungrier and likely alter metabolism, Dr. Buckley says.

Whether genetics will one day help a physician identify which drugs are most likely to have this impact is the focus of another federally funded collaborative study with the University of Iowa being presented at the schizophrenia meeting. “In this study,” says Buckley, “we discovered that a patient’s genetic make-up of their serotonin receptors can predict whether a patient will gain weight or not during treatment with clozapine.”

Another study being presented seeks to give physicians and patients information on which of the newer drugs are best for cognition.

Impaired cognition – problems with the ability to think, learn and remember – has been recognized as a symptom of schizophrenia for more than a century, says Dr. Alvin V. Terry Jr., pharmacist and pharmacologist at the University of Georgia and MCG.

While antipsychotics weren’t developed with cognition in mind, the older ones, called typical antipsychotics, are known to further impede cognition while the newer atypicals are believed to improve it.

Dr. Terry is principal investigator on a $1.1 million grant from the National Institutes of Health examining the impact of long-term use of atypicals.

“We are still finding in most of our cognition studies that the older drugs are worse than the newer drugs, however within the newer drugs, some are better than others,” says Dr. Terry. “Part of my goal is to differentiate the new drugs.”

He started his studies in healthy animal models to first determine the drugs’ impact on cognition, with behavioral tests as well as to analyze the drugs’ impact on different circuitry involved in memory function.

The early findings he’s presenting in Savannah show a modest reduction in this circuitry with long-term use of risperidone or Risperdal®. “What we are finding in this study is that risperidone actually decreases alpha 7 nicotinic receptors in the hippocampus and cortex, big areas for memory,” says Dr. Terry.

As an expert in drug function, he notes that it’s probably impossible to develop a drug that has only positive actions without side effects. But he hopes his research, along with studies such as Dr. Buckley’s, will enable patients to get the most effective drug with the least side effects. Story by Toni Baker

Toni Baker | EurekAlert!
Further information:
http://www.mcg.edu

More articles from Health and Medicine:

nachricht Hot cars can hit deadly temperatures in as little as one hour
24.05.2018 | Arizona State University

nachricht 3D images of cancer cells in the body: Medical physicists from Halle present new method
16.05.2018 | Martin-Luther-Universität Halle-Wittenberg

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Molecular switch will facilitate the development of pioneering electro-optical devices

A research team led by physicists at the Technical University of Munich (TUM) has developed molecular nanoswitches that can be toggled between two structurally different states using an applied voltage. They can serve as the basis for a pioneering class of devices that could replace silicon-based components with organic molecules.

The development of new electronic technologies drives the incessant reduction of functional component sizes. In the context of an international collaborative...

Im Focus: LZH showcases laser material processing of tomorrow at the LASYS 2018

At the LASYS 2018, from June 5th to 7th, the Laser Zentrum Hannover e.V. (LZH) will be showcasing processes for the laser material processing of tomorrow in hall 4 at stand 4E75. With blown bomb shells the LZH will present first results of a research project on civil security.

At this year's LASYS, the LZH will exhibit light-based processes such as cutting, welding, ablation and structuring as well as additive manufacturing for...

Im Focus: Self-illuminating pixels for a new display generation

There are videos on the internet that can make one marvel at technology. For example, a smartphone is casually bent around the arm or a thin-film display is rolled in all directions and with almost every diameter. From the user's point of view, this looks fantastic. From a professional point of view, however, the question arises: Is that already possible?

At Display Week 2018, scientists from the Fraunhofer Institute for Applied Polymer Research IAP will be demonstrating today’s technological possibilities and...

Im Focus: Explanation for puzzling quantum oscillations has been found

So-called quantum many-body scars allow quantum systems to stay out of equilibrium much longer, explaining experiment | Study published in Nature Physics

Recently, researchers from Harvard and MIT succeeded in trapping a record 53 atoms and individually controlling their quantum state, realizing what is called a...

Im Focus: Dozens of binaries from Milky Way's globular clusters could be detectable by LISA

Next-generation gravitational wave detector in space will complement LIGO on Earth

The historic first detection of gravitational waves from colliding black holes far outside our galaxy opened a new window to understanding the universe. A...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Save the date: Forum European Neuroscience – 07-11 July 2018 in Berlin, Germany

02.05.2018 | Event News

Invitation to the upcoming "Current Topics in Bioinformatics: Big Data in Genomics and Medicine"

13.04.2018 | Event News

Unique scope of UV LED technologies and applications presented in Berlin: ICULTA-2018

12.04.2018 | Event News

 
Latest News

When corals eat plastics

24.05.2018 | Ecology, The Environment and Conservation

Surgery involving ultrasound energy found to treat high blood pressure

24.05.2018 | Medical Engineering

First chip-scale broadband optical system that can sense molecules in the mid-IR

24.05.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>