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Effect of antipsychotic drugs on weight gain and metabolic disorders in schizophrenic patients

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Many studies indicate that schizophrenic patients constitute a population encumbered with numerous somatic disorders and a higher mortality, as compared to the general population. We do not know yet, however, what role – in the occurrence of certain disorders (e.g. abdominal obesity, diabetes mellitus and its consequences, circulatory system diseases, metabolic syndrome) – is played by the pathological process itself, patients’ lifestyle, diet and habits, and what is the contribution of antipsychotics in form of typical neuroleptics and new antipsychotics. The results of the studies indicate that these drugs differently affect the weight gains, occurrence of carbohydrate and lipid metabolism disorders or even metabolic syndrome by launching various biological mechanisms. The mechanisms of weight gain associated with antipsychotic treatment assume: increase of appetite, disorders in the basal metabolism, decrease in physical activity, changes in concentrations of neurotransmitters and neuropeptides. Furthermore, it was indicated that a weight loss prior to the treatment might also contribute to the occurrence of obesity. The share of individual factors and their combination may differ among patients. Accounting for differences between antipsychotics in view of their effects on the body weight of treated patients is partially connected with their different antihistaminic (through the impact on receptor H1) or cholinolytic effects, antagonistic effects on serotonin receptor 5HT2C and on concentrations of specific regulators of appetite (e.g. leptin, ghrelin, orexin) and also on the occurrence of disorders within the hypothalamus – pituitary gland – gonads axis or secretion of prolactin.

Słowa kluczowe
schizophrenia, antipsychotics, obesity, weight gain, metabolic disorders