Atypical antipsychotics and diabetic ketoacidosis: a review.

Rationale: Atypical antipsychotics have been linked to weight gain and type 2 diabetes, but are also associated with diabetic ketoacidosis (DKA), which can occur more acutely and in the absence of weight gain.

Objectives: Our aim was to review current case reports of DKA in the context of atypical antipsychotic treatment to better understand (a) the scope of the problem, (b) its relationship to different atypical agents, (c) risk factors, (d) long-term outcome, and (e) putative mechanisms of action.

Method: Searches in PubMed/Medline, as well as the University of Toronto's Scholar Portal, were performed for all relevant articles/abstracts in English.

Smoking cessation in women with severe mental illness: exploring the role of exercise as an adjunct treatment.

Objective: The aim of this study was to investigate the potential role of exercise in smoking cessation in women with severe mental illness (SMI).

Methods: Semistructured interviews with 12 women diagnosed with SMI receiving smoking cessation treatment were conducted.

Results: Participants perceived three roles for exercise in assisting smoking cessation--addressing fears with preexisting chronic health conditions, emotion management and distraction, and weight management.

Psychiatric illness and obesity: recognizing the "obesogenic" nature of an inpatient psychiatric setting.

Objective: The prevalence of obesity and obesity-related diseases is higher among individuals with psychiatric illness than in the general population. This study examined environmental factors that contribute to obesity in one psychiatric hospital in Canada.

Methods: Semistructured interviews were conducted with 25 key stakeholders from multiple professional disciplines at the hospital.

Insulin resistance and decreased glucose-stimulated insulin secretion after acute olanzapine administration.

The newer atypical antipsychotics, as a class, have been associated with an increased risk of weight gain and metabolic abnormalities. The mechanisms underlying this phenomenon are currently unclear, but there are data to suggest the possibility of an immediate (as opposed to chronic) effect of these drugs. The aim of the present study was to assess the acute effects of olanzapine on specific measures of insulin sensitivity and secretion.

Pharmacologic and nonpharmacologic strategies for weight gain and metabolic disturbance in patients treated with antipsychotic medications.

Objectives: To provide an overview of pharmacologic and nonpharmacologic strategies for antipsychotic-associated weight gain and metabolic disturbance, to identify important areas for future research, and to make practice recommendations based on current knowledge.

Methods: We undertook a selective review of interventions for weight gain and metabolic disturbance in the general population and in individuals treated with antipsychotic medications, focusing on randomized controlled trials in schizophrenia.

Results: Pharmacologic strategies include medication choice, medication dosage and formulation, choice of concomitant psychotropic medications, medication switching, medication addition to effect weight loss or prevent weight gain, and medications to increase insulin sensitivity.

Metabolic monitoring for patients treated with antipsychotic medications.

Objectives: Metabolic side effects of antipsychotic treatment include weight gain, dyslipidemia and increased susceptibility to diabetes. Patients with schizophrenia have increased coronary heart disease mortality and reduced life expectancy. There is an urgent clinical need to monitor antipsychotic-treated patients for metabolic disturbance.

Insulin resistance and adiponectin levels in drug-free patients with schizophrenia: A preliminary report.

Objective: To compare the insulin sensitivity and adiponectin levels of medication-free patients suffering from schizophrenia or schizoaffective disorder with that of matched healthy volunteers.

Method: We evaluated 9 nondiabetic patients aged 26.6 years (median 26 years, range 17 to 41 years) and matched volunteers, using the frequently sampled intravenous glucose tolerance test, minimal model analysis, and fasting adiponectin levels.