Not all antipsychotics increase the risk of diabetes. Some drugs may have protective effects

December 20, 2019 / bioun / -- millions of people around the world take antipsychotic drugs every year Although these drugs are effective in treating schizophrenia, they will bring significant side effects, leading to weight gain and diabetes And raise the body cholesterol level, and these factors are the risk factors of cardiovascular disease, cardiovascular disease is the biggest killer of schizophrenia However, the latest research found that not all antipsychotics can cause the same degree of side effects related to diabetes and cardiovascular disease In fact, some antipsychotics may improve blood glucose and cholesterol levels The researchers pooled data from 100 randomized controlled trials (the gold standard of medical research) that analyzed antipsychotic drugs used in short-term treatment (average 6 weeks) of schizophrenia In addition, the researchers analyzed the metabolic side effects of drugs and their association with the change of symptoms in schizophrenics The side effects of patients were weight and BMI The study compared 18 antipsychotic drugs with 100 trials (more than 25000 people) Photo source: fahroni / shutterstock researchers found that there were significant differences in the effects of different antipsychotics on body weight, blood glucose, cholesterol and other fat levels in the blood, especially the two drugs, including clozapine and olanzapine, which had a strong correlation with the increase of body weight, glucose and cholesterol levels These drugs with the strongest side effects only produce metabolic changes in a few weeks, which increases the risk of cardiovascular disease by 76% In contrast, antipsychotics such as lulasidone and carbamazepine are related to the improvement of blood glucose and cholesterol levels The researchers also looked at patients whose body characteristics were better able to predict high levels of metabolic side effects and found that older, non white men were at a higher risk of a large number of metabolic side effects when taking antipsychotics Side effects related to disease improvement The researchers also found that the metabolic side effects of antipsychotics are related to the improvement of symptoms in schizophrenics The more weight the patients gain, the higher the level of cholesterol and the greater the improvement of symptoms One explanation for this phenomenon is that neurotransmitters that mediate metabolic side effects may also help improve the symptoms of diseases Schizophrenics die 20 years earlier than the general population They mainly die of heart disease and stroke Nowadays, antipsychotics have been widely used Some drugs play a key role in increasing the risk of cardiovascular disease Therefore, it is particularly important to understand the side effects of drugs and the differences between different types of drugs and different groups of people In this study, the researchers compared the metabolic side effects of antipsychotics for the first time They tried to determine which people were more likely to suffer from mental illness The significant difference of side effects between different therapies is particularly important for patients to choose antipsychotics, especially for some identified high-risk groups According to the researchers, the relevant research results may be fed back into the treatment guidelines, so as to help clinicians and patients choose the most suitable drugs for them; the choice of drugs should also weigh the benefits of the treatment, the risk of metabolism and other side effects of the body Reference materials: [1] antipsychotic use and expenditure in the United States [2] antipsychotic mediation and weight gain [3] hennekens ch, hennekens AR, holler D, et al Schizophrenia and increased risks of cardiovascular disease Am heart J 2005 Dec; 150 (6): 1115-21 [4] Toby Pillinger, Robert A McCutcheon, Luke Vano， et al Comparative effects of 18 antipsychotics on metabolic function in patients with schizophrenia， predictors of metabolic dysregulation， and association with psychopathology： a systematic review and network meta-analysis ， The Lancet Psychiatry December 17， 2019 doi：10.1016/S2215-0366(19)30416-X 【5】 Not all antipsychotics increase the risk of diabetes and raise cholesterol—some may be protective by Toby Pillinger， The Conversation