Metabole stoornissen bij patiënten met schizofrenie onder tweede generatie antipsychotica

Schizophrenia itself is associated with an increased risk of metabolic disorders such as diabetes, dyslipidaemia and the metabolic syndrome. Recently there is moreover a growing concern on the metabolic side effects of a treatment with the second generation antipsychotics. Fifty percent of patients under a long term treatment with antipsychotics gain weight. The prevalence of diabetes becomes at least twice that of the general population. Around 40 percent meets the criteria of the metabolic syndrome. In Flanders 1/3 of patients with schizophrenia under long term treatment with antipsychotic medication meet the SCORE-risk criteria for statin-treatment and 15% complies with criteria in already the first 3 months after starting an antipsychotic. Treatment with clozapine and olanzapine presents the highest metabolic risk, followed by quetiapine and risperidone. Amisulpride, ziprasidone and aripiprazole appear to exert a low metabolic risk. Thus screening of patients treated with antipsychotics is of the utmost importance due to the high risk of developing metabolic disorders and the increased morbidity and mortality. Screening has not yet become a common practice; these metabolic disorders often stay undiagnosed and untreated. Early detection is important to reduce morbidity and mortality, taking moreover into account the possible reversibility or improvement of the metabolic disorder after switching to an antipsychotic with a safer metabolic profile.status: publishe