Managing the Clinical Consequences of Psychiatric Illness and Antipsychotic Treatment: A Discussion of Obesity, Diabetes, and Hyperprolactinemia

Abstract

Many individuals who suffer from serious and persistent mental illness also have co-occurring physical problems that are frequently misdiagnosed, underdiagnosed, or undertreated. Tragically, this population loses between 8 and 20 years of life expectancy when compared to a nonpsychiatric population. Hyperglycemia, diabetes, and weight gain have long been established as correlating with mental illness and psychotropic medications, leaving it difficult to identify which condition came first. Hyperprolactinemia is an additional consequence of select antipsychotic therapies that results in endocrine and sexual disturbances. Clinicians need to understand how to assess and manage the health risks associated with psychiatric conditions and their treatments. The psychiatric nurse is a key member of the health care team whose holistic framework can afford an opportunity to bridge the gap between mental and physical health. This article discusses the overall assessment and management of psychotropic-associated weight gain, obesity, type 2 diabetes, and hyperprolactinemia in patients with schizophrenia and bipolar disorder.