Patients with schizophrenia are facing hidden threats under the symptoms of mental health: The incidence of diseases and diabetes has continued to rise, which is worrying.Studies have shown that 60%of patients with schizophrenia are overweight or obese.This is in sharp contrast to 35%of the overweight or obese people in ordinary people.
But this is not all.Among patients with schizophrenia, the incidence of type 2 diabetes is two to three times higher.Most of the metabolic side effects, lifestyle factors and potential diseases in the inherent of anti -psychiatric drugs will make the situation worse.Therefore, managing cardiac metabolism must be an indispensable part of the entire treatment system.
When clinicians try to avoid these serious health risks while avoiding the symptoms, they are facing severe challenges.
Metabolic burden of schizophrenia
Various factors lead to an increase in metabolic disorders in patients with schizophrenia.Nursing staff must consider the use of anti -psychiatric drugs, the determination of social health, the choice of genetic tendency and lifestyle.
About one -third of schizophrenia patients suffer from metabolic syndrome, of which 69%of the proportion of chronic diseases is as high as 69%.Obesity, type 2 diabetes, and incidence in this population is three to five times higher.In addition, patients with schizophrenia are diagnosed with cardiovascular disease and the chances of death are twice as many as normal people.This exacerbates a very different mortality gap between patients with schizophrenia and ordinary people.
Although anti -psychiatric drugs can effectively control mental symptoms, it will also increase the risk of metabolic complications.In particular, the second -generation anti -psychiatric drugs will cause severe damage to metabolism.Studies have revealed side effects such as weight gain, glucose steady state changes, and abnormal blood lipids.All these will affect the risk of cardiovascular disease and type 2 diabetes.
Lifetime factors-and common medical services in serious mental illness-have exacerbated these adverse effects.This may cause patients to not persist in treatment, and even completely abandon treatment, threatening long -term spiritual treatment effects.
Selection and treatment adjustment of anti -psychiatric drugs
Clinicians can help patients avoid long -term complications while effectively controlling symptoms.
Before starting treatment, evaluate the metabolic risk of anti -psychiatric drugs.
According to personal risk factors, choose anti -psychiatric drugs in a targeted manner.
In the case of appropriate clinic, consider choosing drugs with lower metabolic risks.The second generation of anti-psychiatric drugs-especially octopatopatpum and chlorodine-have high risk of weight gain, insulin resistance and abnormal blood lipids.Other second -generation anti -psychiatric drugs, such as Tellasone and Zirazone, Allazazole, as well as thor Petrazole and Kalirazine, have low metabolic burdens.
Clinicians should start anti -psychiatric treatment at the recommended minimum dose, and slowly drop to the minimum effective dose to balance in order to balanceThe effects and possible metabolic side effects.Guidelines for the American Psychiatry Association (APA) suggested that patients who receive anti -psychiatric drug treatment should receive baseline and conventional monitoring of weight, weight index (BMI), blood lipids and blood sugar control laboratories in order to detect and solve metabolic problems early.
New treatment methods for weight management
When prescribing anti -psychiatric drugs, there is no way to avoid metabolic risk.However, clinicians can rely on some auxiliary therapies to control weight.
Facts have proved that the dual -duplex can prevent and treat the weight increase related to anti -psychiatric drugs.Studies have shown that compared with placebo, patients with anti -psychiatric drugs take dual -double after taking dual -dual -dual -duality, and the average weight decreases by 3.3 kilograms.In addition to inhibiting the weight gain, the dual -dual -dual -dual -dual -dual -dual -dual -dual -dual -duplex can also promote the absorption of glucose peripherals, reduce the production of liver glucose, and reduce the sensitivity of insulin.
Pan-high blood sugar-like peptide -1 (GLP-1) receptor agonist, initialIt is developed for the treatment of type 2 diabetes. It has the benefits of promoting weight loss, improving blood sugar control and the treatment of metabolic complications, such as fatty liver dysfunction related to metabolic dysfunction (previously called non -alcoholic fatty liver).
In a 3 -phase test for an overweight or obese adult, SimeThe average weight change rate of 2.4 mg was 14.9%, while the average weight change rate of placebo therapy patients within 68 weeks was only 2.4%.
Urpo peptide, a GLP-1/glucose dependence of insulin polypeptide (GIP) Double excitement has a greater impact on weight.A 72 -week test showed that taking 15 mg of doerpla peptides per week can reduce the average weight by more than 20%, and the weight loss effect of placebo is only 3.1%.
2017 aimed at receiving ozine or chloropapatic treatment, early diabetes, pre -weight, super weightEither patients with obesity schizophrenia show that compared with placebo, Licolatic peptide is 1.8 mg per day, and the average weight of 5.3 kg within 16 weeks.Among the patients who were treated with Leralugu, 63.8%of patients were rejuvenating their glucose tolerance, and only 16%of patients were recovered normally among patients receiving placebo therapy.
New treatment method
Symptoms promote the needs of new therapy.
Ozine and Olz/Sam (Olz/Sam) obtained FDA approval in 2021, throughAdding opioids, Seminfen, can usually reduce or prevent weight gain while maintaining the curative effect.The post-after-to-the-after analysis of the 3-stage test Enlighten-2 shows that compared with Ozine, OLZ/SAMs obesity, hypertension and metabolic syndrome worsening risk is low.
xanomeline-Trospium (karxt) is a new typeAt the end of September this year, it was approved by the US Food and Drug Administration.The latest summary data of the Emerger-4 and Emergent-5 test provides encouraging long-term metabolic results, and the average weight loss will be reduced by 2.6 kilograms after one year.Throughout the treatment, key metabolic indicators such as total cholesterol, triglyceride, and A1C have remained stable.
UlotAnt is a trace amine -related receptor 1 (TAAR1) agonist, and it is also expected to become a new type of emerging drugs for the treatment of schizophrenia.The US Food and Drug Administration (FDA) awarded its titles of breakthrough therapy in 2019.A 26 -week open label extension research data shows that the drug has no clinical changes in weight, cholesterol, triglycerides or A1C levels.
Emerging therapy is expected to reduce the risk of weight gain, metabolic syndrome and type 2 diabetes in patients with schizophrenia, clinicians will soon have moreAvailable tools to improve nursing and long -term efficacy.
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