Physical Fitness, Health Should be Factors in Antipsychotic Use: Experts

Health care providers should take a patient’s physical health and fitness into account when deciding whether to prescribe many popular antipsychotic medications, experts warned in a recently published medical journal article. 

The major cause of death for patients with severe mental illness is heart disease, often caused by weight gain and diabetes brought on, or exacerbated, by the use of antipsychotic drugs, according to the authors of an editorial in The Lancet medical journal. However, some of the side effects of antipsychotics could be mitigated if doctors and psychiatrists take a more overall look at the patient’s health and factor in diet, physical activity, smoking and other factors.

The use of antispychotics such as Seroquel, Zyprexa and Risperdal, have often been associated with weight gain and diabetes.

A recent study in the Archives of General Psychiatry found that patients gained 11 to 13 pounds after taking Zyprexa for six to eight weeks. The patients also experienced increases in glucose, cholesterol, triglycerides, and in insulin levels when given a variety of atypical antipsychotics.

In light of these new findings and other studies, the editorial writers recommend that mental health care providers assess patients’ physical health when providing mental health care and medications, and take a more active role in patients’ health in conjunction with primary healthcare providers.

Atypical antipsychotics generate more than $12 billion in sales every year, with Seroquel leading the pack with nearly $4.45 billion in sales last year.

Last week it was reported that AstraZeneca has agreed to pay $350 million to settle Seroquel diabetes lawsuits, which involve claims filed by former users who allege that the drug maker failed to adequately warn about the risk of weight gain and diabetes.

As of December, the drug maker had paid $738 million in legal costs associated with Seroquel litigation. The company also paid an additional $520 million last year to settle criminal allegations by the U.S. Department of Justice (DOJ) that it illegally marketed Seroquel for off-label uses.

While doctors are free to prescribe approved medications for non-approved uses, drug makers are barred from promoting or encouraging such “off-label” use. Since it was approved, Seroquel has been used by more than 19 million people worldwide, and some people have estimated that at one time as much as 70% of all seroquel prescriptions were for unapproved uses.