Krissy Reinstatler, PharmD, BCPP, MBA
CPNP Programming Committee Member
People with schizophrenia have a life expectancy 20 years less than the general population1, with more than a third of these deaths attributable to cardiovascular disease (CVD) and type 2 diabetes2. The increased risk of cardiometabolic disease is multifactorial and contributing causes include glucose dysregulation and weight gain associated with antipsychotic medications.2 The prevalence of obesity among people with psychotic disorders is 41–50%, which is substantially higher than the 20–27% prevalence in the general population.3 Many antipsychotics are associated with weight gain and other metabolic complications.4 In fact, studies suggest 50% of patients treated with antipsychotics develop metabolic syndrome5 and the prevalence of metabolic syndrome is higher in patients treated with antipsychotics than in drug naive patients with schizophrenia4.
Identification and treatment of metabolic syndrome are imperative to prevent possible progression to diabetes or CVD and improve an individual’s overall health. Studies have examined a variety of approaches, including off-label uses of medications for weight-management and adjunctive antipsychotics with a more metabolically neutral side effect profile. A 2014 meta-analysis found 19 distinct interventions for antipsychotic-induced weight gain.6 The British Association for Psychopharmacology has recently created guidelines to address aspects of monitoring and management of risk factors for diabetes and CVD in adults over the age of 18 years with psychosis. The main interventions recommended in these guidelines are lifestyle interventions, antipsychotic switching, adjunctive aripiprazole, and adjunctive metformin.1 One of the antipsychotics known to have some of the most deleterious effects on cardiometabolic health is olanzapine. A combination of olanzapine and the opioid modulator samidorphin to reduce weight gain and metabolic impact is currently in clinical trials.7
To assist clinicians in navigating treatment options for antipsychotic-induced metabolic events, Christopher Correll, MD, will be speaking at the 2020 CPNP annual meeting in Dallas, Texas.
Specific objects for Dr. Correll’s talk include:
Dr. Correll is a professor at the Center for Psychiatric Neuroscience of the Feinstein Institutes for Medical Research, the Medical Director of the Recognition and Prevention (RAP) Program in the Department of Psychiatry at Zucker Hillside Hospital, and a professor of psychiatry and molecular medicine at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. Dr. Correll’s research and clinical work focus on the identification, characterization and psychopharmacological management of adults and youth with severe psychiatric disorders. His areas of expertise include schizophrenia, bipolar disorder, major depression and other psychotic, mood and autism/disruptive behavior spectrum disorders. His work focuses on the risk-benefit evaluation of psychotropic medications, including the interface between psychiatry and medicine and investigations of the extent and mechanisms of cardiometabolic adverse effects.