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Psychopharmaka und Diabetes

Psychotropic drugs and diabetes

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Summary

Psychotropic drugs, such as antipsychotics and antidepressants, are widely used substances which can display marked metabolic side effects. Psychiatric patients display increased morbidity and mortality which, besides disease specific factors, may be attributed to metabolic side effects of psychotropic drugs. Commonly observed side effects of antipsychotics are weight gain as well as disturbances in glucose and lipid metabolism. Additionally, antipsychotics have been shown to increase diabetes risk. Also, the use of some of the antidepressant substances is associated with an increased diabetes risk. However, large inter-substance variations have been observed. Conversely, diabetics have an increased risk of depression. Metabolic side effects of psychotropic drugs pose a serious impairment for psychiatric patients and their management can play a pivotal role in therapeutic compliance and success. This review aims to give an overview of metabolic side effects of commonly used psychotic drugs and to give an insight into possible underlying mechanisms.

Zusammenfassung

Psychopharmaka, wie zum Beispiel Antipsychotika oder Antidepressiva, sind weit verbreitete Substanzen, welche in vielen Fällen ein ungünstiges metabolisches Nebenwirkungsprofil aufweisen. Die zu erwartenden metabolischen Nebenwirkungen unter Antipsychotikatherapie umfassen eine teilweise stark ausgeprägte Gewichtszunahme, eine Erhöhung des Diabetesrisikos und die Ausbildung eines atherogenen Lipidprofils. Die Einnahme von Antidepressiva geht ebenfalls mit einem erhöhten Risiko an Diabetes zu erkranken einher, wobei große Unterschiede zwischen den einzelnen Substanzen bestehen. Zusätzlich scheint es sich um eine wechselseitige Beziehung zwischen Depressionen und Diabetes zu handeln, da Diabetiker ein signifikant höheres Risiko haben an Depressionen zu erkranken als die Normalbevölkerung. Metabolische Nebenwirkungen von Psychopharmaka stellen eine ernst zu nehmende Beeinträchtigung für psychisch kranke Patienten dar und ihre Behandlungsregime können einen entscheidenden Faktor für die Compliance und damit einhergehend dem Therapieerfolg der betroffenen Patienten darstellen. Dieser Beitrag soll einen Überblick über die metabolischen Nebenwirkungen häufig verwendeter Psychopharmaka und einen Einblick in mögliche zugrundeliegende Mechanismen bieten.

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  1. Department für Innere Medizin I, Medizinische Universität Innsbruck, Austria

    Claudia Ress, Alexander Tschoner, Susanne Kaser & Christoph F. Ebenbichler

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  1. Claudia Ress
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  2. Alexander Tschoner
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  3. Susanne Kaser
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  4. Christoph F. Ebenbichler
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Correspondence to Christoph F. Ebenbichler.

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Ress, C., Tschoner, A., Kaser, S. et al. Psychopharmaka und Diabetes. Wien Med Wochenschr 161, 531–542 (2011). https://doi.org/10.1007/s10354-011-0004-9

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