Managing Metabolic Abnormalities in the Psychiatrically Ill: A Clinical Guide for Psychiatrists

328 Pages·2006·2.97 MB·English

by  Richard A. Bermudes

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MANAGING
METABOLIC ABNORMALITIES
IN THE PSYCHIATRICALLY ILL
A Clinical Guide for Psychiatrists
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MANAGING
METABOLIC ABNORMALITIES
IN THE PSYCHIATRICALLY ILL
A Clinical Guide for Psychiatrists
Edited by
Richard A. Bermudes, M.D.
Paul E. Keck Jr., M.D.
Susan L. McElroy, M.D.
Washington, DC
London, England
Note: The authors have worked to ensure that all information in this book is accurate at
the time of publication and consistent with general psychiatric and medical standards, and
that information concerning drug dosages, schedules, and routes of administration is accu-
rate at the time of publication and consistent with standards set by the U.S. Food and Drug
Administration and the general medical community. As medical research and practice con-
tinue to advance, however, therapeutic standards may change. Moreover, specific situations
may require a specific therapeutic response not included in this book. For these reasons and
because human and mechanical errors sometimes occur, we recommend that readers follow
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Copyright © 2007 American Psychiatric Publishing, Inc.
ALL RIGHTS RESERVED
Manufactured in the United States of America on acid-free paper
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First Edition
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Library of Congress Cataloging-in-Publication Data
Managing metabolic abnormalities in the psychiatrically ill : a clinical guide for psychiatrists
/ edited by Richard A. Bermudes, Paul E. Keck Jr., Susan L. McElroy.
p. ; cm.
Includes bibliographical references and index.
ISBN 1-58562-241-9 (pbk. : alk. paper)
1. Metabolism–Disorders. 2. Cardiovascular system–Diseases. 3. Mentally ill—
Diseases. 4. Mentally ill—Health and hygiene. 5. Psychotropic drugs—Side effects.
I. Bermudes, Richard A., 1967– II. Keck, Paul E. III. McElroy, Susan L. [DNLM:
1. Mental Disorders—complications. 2. Antipsychotic Agents—adverse effects.
3. Cardiovascular Diseases—complications. 4. Diabetes Complications. 5. Metabolic
Syndrome X—complications. 6. Obesity—complications. WM 140 M266 2007]
RC627.6.M36 2007
′
616.39—dc22
2006031098
British Library Cataloguing in Publication Data
A CIP record is available from the British Library.
CONTENTS
Contributors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
Preface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi
Richard A. Bermudes, M.D.
Paul E. Keck Jr., M.D.
Susan L. McElroy, M.D.
1 Diabetes: An Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
David D’Alessio, M.D.
2 The Metabolic Syndrome. . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Robert M. McCarron, D.O.
Craig R. Keenan, M.D.
3 Severe Mental Illness and Obesity. . . . . . . . . . . . . . . . . . . . . 55
Susan L. McElroy, M.D.
Anna Guerdjikova, Ph.D.
Renu Kotwal, M.D.
Paul E. Keck Jr., M.D.
4 Severe Mental Illness and Diabetes Mellitus . . . . . . . . . . . . 121
Paul E. Keck Jr., M.D.
Susan L. McElroy, M.D.
Rakesh Kaneria, M.D.
5 Cardiovascular Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Richard A. Bermudes, M.D.
6 Antipsychotic-Associated Weight Gain:
A Synthesis and Clinical Recommendations. . . . . . . . . . . . . 165
Roger S. McIntyre, M.D., F.R.C.P.C.
Joanna K. Soczynska, B.Sc.
Kamran Bordbar, M.D.
Jakub Z. Konarski, M.Sc.
7 Glucose Metabolism: Effects of Atypical Antipsychotics. . . 203
John W. Newcomer, M.D.
8 Serum Lipids: Effects of Antipsychotics . . . . . . . . . . . . . . .239
Jonathan M. Meyer, M.D.
9 Metabolic Risk Assessment, Monitoring, and Interventions:
Translating What We Have Learned Into Practice. . . . . . . . .277
Richard A. Bermudes, M.D.
Paul E. Keck Jr., M.D.
Susan L. McElroy, M.D.
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .303
CONTRIBUTORS
Richard A. Bermudes, M.D.
Assistant Clinical Professor, Department of Psychiatry and Behavioral Sciences,
University of California, Davis Medical Center, Sacramento, California
Kamran Bordbar, M.D.
Resident in Psychiatry, Centre of Addiction & Mental Health, Toronto, Ontario,
Canada
David D’Alessio, M.D.
Professor, Department of Medicine, Vontz Chair for Diabetes Research, Univer-
sity of Cincinnati, Cincinnati, Ohio
Anna Guerdjikova, Ph.D.
Postdoctoral Fellow, Psychopharmacology Research Program, Department of Psy-
chiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio
Rakesh Kaneria, M.D.
Assistant Professor of Clinical Psychiatry, Psychopharmacology Research Program,
Department of Psychiatry, University of Cincinnati College of Medicine, Cincin-
nati, Ohio
Paul E. Keck Jr., M.D.
President and CEO of the Craig and Frances Lindner Center of HOPE and Lind-
ner Professor of Psychiatry and Neuroscience and Executive Vice Chairman of the
Department of Psychiatry at the University of Cincinnati College of Medicine in
Cincinnati, Ohio
Craig R. Keenan, M.D.
Assistant Clinical Professor, Department of Internal Medicine, University of Cal-
ifornia, Davis, Sacramento, California
Jakub Z. Konarski, M.Sc.
Doctoral candidate, Institute of Medical Science, University of Toronto, Toronto,
Ontario, Canada
vii
viii Managing Metabolic Abnormalities in the Psychiatrically Ill
Renu Kotwal, M.D.
Assistant Professor of Clinical Psychiatry, Psychopharmacology Research Program,
Department of Psychiatry, University of Cincinnati College of Medicine, Cincin-
nati, Ohio
Robert M. McCarron, D.O.
Assistant Clinical Professor, Department of Psychiatry and Behavioral Sciences,
Department of Internal Medicine, University of California, Davis, Sacramento,
California
Susan L. McElroy, M.D.
Professor of Psychiatry and Neuroscience, Psychopharmacology Research Pro-
gram, Department of Psychiatry, University of Cincinnati College of Medicine,
Cincinnati, Ohio
Roger S. McIntyre, M.D., F.R.C.P.C.
Associate Professor, Department of Psychiatry and Pharmacology, University of
Toronto; Head, Mood Disorders Psychopharmacology Unit, University Health
Network, Toronto, Ontario, Canada
Jonathan M. Meyer, M.D.
Assistant Professor of Psychiatry in Residence, University of California, San Di-
ego; Staff Psychiatrist, Veterans Affairs San Diego Healthcare System, San Diego,
California
John W. Newcomer, M.D.
Professor of Psychiatry, Psychology, and Medicine; Medical Director, Clinical
Studies, Washington University School of Medicine, St. Louis, Missouri
Joanna K. Soczynska, B.Sc.
Masters of Science Candidate, Institute of Medicine, University of Toronto, Tor-
onto, Ontario, Canada
Disclosure of Competing Interests
Richard A. Bermudes, M.D.—Research: Abbott Laboratories; Eli Lilly and Com-
pany; Speaker bureau: Abbott Laboratories; Bristol-Myers Squibb, Eli Lilly and
Company, Pfizer
Kamran Bordbar, M.D.—None to report
David D’Alessio, M.D.—Grant support: Amylin, Eli Lilly and Company, Novartis;
Consultant: Amylin, Merck, Novartis