Schizophrenic patients have a life expectancy 20% shorter than general population, mainly due to cardiovascular disease. Several risk factors for cardiovascular disease are modifiable, and some, like blood glucose and lipids, and weight, can be worsened by antipsychotic drugs, mainly second generation ones. This article reviews the concept of metabolic syndrome and its relationship with schizophrenia and antipsychotic drugs. It also reviews the relationship between obesity, abdominal fat and schizophrenia, and the influence that second generation antipsychotics may have on weight. Antipsychotics are differentiated according to their liability of inducing weight gain, possible physiopathological mechanisms for weight gain are mentioned, and main pharmacological treatments to revert or prevent this situation are discussed. Some parameters for the periodic monitoring of the constitutive elements of metabolic syndrome to be used by psychiatrist in patients taking second generation antipsychotics are suggested.

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