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Metabolic and Endocrine Disturbances in Psychiatric Disorders: A Multidisciplinary Approach to Appropriate Atypical Antipsychotic Utilization

Published online by Cambridge University Press:  07 November 2014

Prakash S. Masand
Dr. Culpepper is professor and chairman in the Department of Family Medicine at, Boston University School of Medicinein Massachusetts. He is a consultant to Eli Lilly, Forest, Pfizer, and Wyeth.
Larry Culpepper
Dr. Henderson is associate professor of psychiatry in the Department of Psychiatry at Harvard Medical School in Boston, Massachusetts. He is on the speaker's bureaus of AstraZeneca, Bristol-Myers Squibb, Janssen, and Pfizer; and receives grant/research support from AstraZeneca, Bristol-Myers Squibb, Eli Lilly, and Pfizer.
David Henderson
Dr. Lee is director of the Diabetes Research Center at, Loma Linda University Medical Centerin California. He is a consultant to Medtronic and Pfizer; is on the speaker's bureaus of Aventis, GlaxoSmithKline, Medtronic, and Pfizer; and receives grant/research support from GlaxoSmithKline.
Scott Lee
Ms. Littrell is adjunct professor in the College of Health Sciences, Georgia State University, in Atlanta, Georgia. She is a consultant to AstraZeneca, Bristol-Myers Squibb, Janssen, and Solvay; is on the speaker's bureaus of AstraZeneca, Bristol-Myers Squibb, Eli Lilly, and Janssen; and receives grant/research support from Bristol-Myers Squibb and Janssen.
Kimberly Littrell
Dr. Masand is consulting professor of psychiatry in the Department of Psychiatry at, Duke University Medical Centerin Durham, North Carolina. He is a consultant to Bristol-Myers Squibb, Forest, GlaxoSmithKline, Health Care Technology, Janssen, Organon, Pfizer, and Wyeth; is on the speaker's bureaus of Abbott, AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Forest, GlaxoSmithKline, Janssen, Novartis, Pfizer, and Wyeth; receives grant/research support from AstraZeneca, Bristol-Myers Squibb, Forest, GlaxoSmithKline, Ortho-McNeil, Janssen, and Wyeth; and owns stock in psychCME, Inc.
John W. Newcomer
Dr. Newcomer is associate professor of psychiatry in the Department of Psychiatry at, Washington University School of Medicinein St. Louis, Missouri. He is a consultant to AstraZeneca, Bristol-Myers Squibb, GlaxoSmithKline, Janssen, and Pfizer; and receives grant/research support from Bristol-Myers Squibb, Janssen, The National Alliance for Research on Schizophrenia and Depression (NARSAD), the National Institute of Mental Health, Pfizer, and the Sidney R. Baer Foundation.
Natalie Rasgon
Dr. Rasgon is associate professor of psychiatry in the Department of Psychiatry at Stanford University School of Medicine in Stanford, California. She is a consultant to Abbott and Wyeth; is on the speaker's bureaus of Abbott, Bristol-Myers Squibb, Eli Lilly, Forest, GlaxoSmithKline, Novartis, Pfizer, and Wyeth; and receives or has received grant/research support from Abbott, Breast Cancer Research Foundation, Forest, GlaxoSmithKline, NARSAD, the National Institute on Aging, the National Institute of Mental Health, Solvay, the Stanley Foundation, the Thyroid Research Advisory Council, and UCLA Opportunities Funding.


Patients with psychiatric disorders have an increased rate of cardiovascular morbidity and mortality compared with the general population. Metabolic issues such as weight gain, dyslipidemia, diabetes mellitus, diabetic ketoacidosis, and pancreatitis have been reported with the use of antipsychotic agents. Although atypical antipsychotics have not been linked directly to the development of metabolic syndrome, these medications have been shown to increase risk factors that can lead to metabolic and endocrine disturbances. Therefore, clinicians should provide ongoing monitoring for patients who are being treated for psychiatric disorders with these agents. According to the 2004 Consensus Report on Antipsychotics, screening measures should include baseline and follow-up monitoring of personal/family histories, weight (body mass index), waist circumference, blood pressure, fasting plasma glucose, and fasting lipid profile.

Research Article
Copyright © Cambridge University Press 2005

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