Metabolic syndrome in schizophrenia: how much is attributable to drug treatment?

In the last two decades, the use of second generation antipsychotics has superseded first generation antipsychotics mainly because of their lower propensity to cause the troublesome extra-pyramidal side effects and claims of efficacy in treatment of negative and cognitive symptoms. But in last few years, various metabolic complications in the form of weight gain, glucose intolerance leading to diabetes mellitus and lipid disturbances in the form of hypertriglyceridemia and low protective HDL cholesterol surfaced the clinical scenario in psychiatric practice. The increased health damages with clustering of these metabolic parameters led to the gradual concept of syndrome X, Insulin resistance syndrome and finally metabolic syndrome. Studies in different parts of world established the high prevalence of metabolic syndrome in patients of schizophrenia which was further increased by antipsychotics (second generation). Schizophrenia and other psychotic disorders decrease life expectancy by 20% with the standardized mortality rate being twice as compared to general population and cardiovascular illnesses remain the most important overall cause accounting for over 60% of the total deaths in schizophrenia. 1 ABSTRACT