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Case 26 - “I Am a Worrier”

Schizoaffective Disorder and Antipsychotics

Published online by Cambridge University Press:  31 October 2024

Matthew Gibfried
Affiliation:
Saint Louis University School of Medicine, Missouri
George T. Grossberg
Affiliation:
Saint Louis University School of Medicine, Missouri
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Summary

Schizoaffective disorder is a psychiatric disorder in which patients demonstrate a combination of symptoms associated with schizophrenia and a mood disorder such as bipolar disorder or depression. The symptoms of schizophrenia and mood disorder occur concomitantly for a substantial portion of the illness duration. If a resident has been stable on a psychiatric drug regimen, it is advisable to avoid any major change because obtaining a similar good therapeutic response from a different drug regimen is not predictable or assured. All antipsychotics have the potential to cause weight gain and increase the risk of obesity and related hyperlipidemia and diabetes. Atypical antipsychotics can be thought of as being high, medium, and low risk for these complications. Antipsychotics thought to be low risk for metabolic syndrome include cariprazine, lurasidone, lumateperone, ziprasidone, pimavanserin, aripiprazole, and brexpiprazole.

Type
Chapter
Information
Clinical Case Studies in Long-Term Care Psychiatry
Navigating Common Mental Health Challenges in Geriatric Care
, pp. 126 - 129
Publisher: Cambridge University Press
Print publication year: 2024

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References

References

Szmulewicz, A. G., Angriman, F., Pedroso, F. E., Vazquez, C., & Martino, D. J. (2017). Long-term antipsychotic use and major cardiovascular events: A retrospective cohort study. The Journal of Clinical Psychiatry, 78 (8), 1161.CrossRefGoogle ScholarPubMed
Stahl, S. M. (2021). Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. 5th ed. (Cambridge University Press.) Ebook. Kindle Edition. p. 212.CrossRefGoogle Scholar

Further Reading

Bernardo, M., Rico-Villademoros, F., García-Rizo, C., Rojo, R., & Gómez-Huelgas, R. (2021). Real-world data on the adverse metabolic effects of second-generation antipsychotics and their potential determinants in adult patients: A systematic review of population-based studies. Advances in Therapy, 38 (5), 24912512. www.ncbi.nlm.nih.gov/pmc/articles/PMC8107077/CrossRefGoogle ScholarPubMed
Carli, M., Kolachalam, S., Longoni, B., Pintaudi, A., Baldini, M., Aringhieri, S., & Scarselli, M. (2021). Atypical antipsychotics and metabolic syndrome: From molecular mechanisms to clinical differences. Pharmaceuticals, 14 (3), 238.CrossRefGoogle ScholarPubMed
DeJongh, B. M. (2021). Clinical pearls for the monitoring and treatment of antipsychotic induced metabolic syndrome. Mental Health Clinician, 11 (6), 311319.CrossRefGoogle ScholarPubMed
Friedrich, M. E., Winkler, D., Konstantinidis, A., Huf, W., Engel, R., Toto, S., Grohmann, R., & Kasper, S. (2020). Cardiovascular adverse reactions during antipsychotic treatment: Results of AMSP, a drug surveillance program between 1993 and 2013. The International Journal of Neuropsychopharmacology, 23 (2), 6775. https://doi.org/10.1093/ijnp/pyz046CrossRefGoogle ScholarPubMed
Hammoudeh, S., Al Lawati, H., Ghuloum, S., Iram, H., Yehya, A., Becetti, I., & Al-Amin, H. (2020). Risk factors of metabolic syndrome among patients receiving antipsychotics: A retrospective study. Community Mental Health Journal, 56, 760770.CrossRefGoogle ScholarPubMed
Sneller, M. H., De Boer, N., Everaars, S., Schuurmans, M., Guloksuz, S., Cahn, W., & Luykx, J. J. (2021). Clinical, biochemical and genetic variables associated with metabolic syndrome in patients with schizophrenia spectrum disorders using second-generation antipsychotics: a systematic review. Frontiers in Psychiatry, 12, 625935.CrossRefGoogle ScholarPubMed
Ventriglio, A., Baldessarini, R. J., Vitrani, G., Bonfitto, I., Cecere, A. C., Rinaldi, A., & Bellomo, A. (2019). Metabolic syndrome in psychotic disorder patients treated with oral and long-acting injected antipsychotics. Frontiers in Psychiatry, 9, 744.CrossRefGoogle ScholarPubMed

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  • “I Am a Worrier”
  • Matthew Gibfried, Saint Louis University School of Medicine, Missouri, George T. Grossberg, Saint Louis University School of Medicine, Missouri
  • Book: Clinical Case Studies in Long-Term Care Psychiatry
  • Online publication: 31 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781108630344.027
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Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • “I Am a Worrier”
  • Matthew Gibfried, Saint Louis University School of Medicine, Missouri, George T. Grossberg, Saint Louis University School of Medicine, Missouri
  • Book: Clinical Case Studies in Long-Term Care Psychiatry
  • Online publication: 31 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781108630344.027
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • “I Am a Worrier”
  • Matthew Gibfried, Saint Louis University School of Medicine, Missouri, George T. Grossberg, Saint Louis University School of Medicine, Missouri
  • Book: Clinical Case Studies in Long-Term Care Psychiatry
  • Online publication: 31 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781108630344.027
Available formats
×