Antipsychotic medication information

Antipsychotics are pharmaceutical drugs used to treat certain mental disorders.

Metabolic considerations in the use of antipsychotic medications: a review of recent evidence.
J Clin Psychiatry. 2007;68 Suppl 1:20-7. Newcomer JW. From the Departments of Psychiatry, Psychology, and Medicine, Washington University School of Medicine, St. Louis, Mo.
Compared with the general population, persons with schizophrenia have up to a 20% shorter lifespan, with cardiovascular disease as the leading cause of death. In addition, persons with schizophrenia have increased prevalence of the metabolic syndrome (obesity, insulin resistance, dyslipidemia, impaired glucose tolerance, and hypertension), increased prevalence of risk factors such as smoking, poverty, and poor nutrition, and reduced access to medical care. Results from the recent Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) provide further evidence of the metabolic risk associated with different atypical antipsychotic medications. Based on this study and a growing number of other randomized clinical trials, clozapine and olanzapine treatment can produce substantial mean changes in weight and an increased risk of associated metabolic disturbances. Risperidone and quetiapine treatment can produce intermediate changes in mean weight in comparison to treatment with other atypical antipsychotic medications, with discrepant results with respect to metabolic risk. Aripiprazole and ziprasidone treatment induced the lowest mean changes in weight gain and had no effect on risk for adverse metabolic changes, among currently available atypical agents.

Antipsychotic medication in the treatment of delirium: a systematic review.
J Clin Psychiatry. 2007 Jan;68(1):11-21. Department of Psychiatry, Queen's University, Kingston, Ontario, Canada.
Antipsychotic medications are frequently used in the management of delirium, although there is limited information regarding the safety and efficacy of antipsychotic medications in treating delirium. The purpose of this study was to systematically evaluate the evidence for the efficacy and safety of antipsychotic medications in treating delirium. Study medications included haloperidol, chlorpromazine, olanzapine, risperidone, and quetiapine. Improvements in delirium severity were reported with all of these antipsychotic medications. No study included a placebo comparison to account for spontaneous improvements in delirium. Other methodological limitations included inadequate blinding, randomization, and handling of participant withdrawals. The improvements in delirium tended to occur soon after initiation of treatment, and most of the studies examined used relatively low doses of antipsychotic medication. Serious adverse events attributable to antipsychotic medication were uncommon in studies, although side effects were not evaluated systematically in most studies. CONCLUSION: To date, there are no published double-blind, randomized, placebo-controlled trials to establish the efficacy or safety of any antipsychotic medication in the management of delirium. There is limited evidence from uncontrolled studies that supports the use of low-dose, short-term treatment of delirium with some antipsychotic medications. Further study with well-designed clinical trials is required in this area.

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