University of Worcester Worcester Research and Publications

BAP Guidelines on the Management of Weight Gain, Metabolic Disturbances and Cardiovascular Risk Associated With Psychosis and Antipsychotic Drug Treatment

Cooper, S.J., Reynolds, G.P., Barnes, T.R.E., England, E., Haddad, P.M., Heald, A., Holt, R.I.G., Lingford-Hughes, A., Osborn, D., McGowan, O., Patel, M.X., Paton, C., Reid, P., Shiers, D. and Smith, Jo (2016) BAP Guidelines on the Management of Weight Gain, Metabolic Disturbances and Cardiovascular Risk Associated With Psychosis and Antipsychotic Drug Treatment. Journal of Psychopharmacology, 30 (8). pp. 717-748. ISSN Print: 0269-8811 Online: 1461-7285

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Excess deaths from cardiovascular disease are a major contributor to the significant reduction in life expectancy experienced by people with schizophrenia. Important risk factors in this are smoking, alcohol misuse, excessive weight gain and diabetes. Weight gain also reinforces service users’ negative views of themselves and is a factor in poor adherence with treatment. Monitoring of relevant physical health risk factors is frequently inadequate, as is provision of interventions to modify these. These guidelines review issues surrounding monitoring of physical health risk factors and make recommendations about an appropriate approach. Overweight and obesity, partly driven by antipsychotic drug treatment, are important factors contributing to the development of diabetes and cardiovascular disease in people with schizophrenia. There have been clinical trials of many interventions for people experiencing weight gain when taking antipsychotic medications but there is a lack of clear consensus regarding which may be appropriate in usual clinical practice. These guidelines review these trials and make recommendations regarding appropriate interventions. Interventions for smoking and alcohol misuse
are reviewed, but more briefly as these are similar to those recommended for the general population. The management of impaired fasting glycaemia and impaired glucose tolerance (‘pre-diabetes’), diabetes and other cardiovascular risks, such as dyslipidaemia, are also reviewed with respect to other currently available guidelines. These guidelines were compiled following a consensus meeting of experts involved in various aspects
of these problems. They reviewed key areas of evidence and their clinical implications. Wider issues relating to primary care/secondary care interfaces are discussed but cannot be resolved within guidelines such as these.

Item Type: Article
Additional Information:

Staff and students at the University of Worcester can access the full-text via the UW online library search. External users should check availability with their local library or Interlibrary Requests Service.

Uncontrolled Discrete Keywords: Alcohol misuse, antipsychotic, aripiprazole, cardiovascular disease, diabetes, dyslipidaemia, guidelines, interventions for weight gain, lifestyle, metformin, obesity, overweight, psychosis, risk assessment, schizophrenia, smoking cessation, switching
Subjects: R Medicine > R Medicine (General)
Divisions: College of Health, Life and Environmental Sciences > School of Allied Health and Community
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Depositing User: Tanya Buchanan
Date Deposited: 07 Jul 2016 08:53
Last Modified: 14 Jul 2020 13:15

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