December 27, 2009, 08:00:00AM. By Gordon Gibb

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Washington, DC: A new study of antipsychotics, including Seroquel, notes that the medications are reasonably effective and well-tolerated treatments for mood and psychotic disorders, but they do have a dark side—side effects that cause diabetes and hyperglycemia, among other adverse reactions.

The most recent issue of Biological Psychiatry addresses metabolic side effects and how they may contribute to the risk for diabetes, hypertension and other medical disorders associated with heart disease. Given the higher cardiovascular mortality among the severely mentally ill compared to the general population, it's a serious concern.

Researchers used data from the multi-center CATIE (Clinical Antipsychotic Trials of Intervention Effectiveness) study, funded by the National Institute of Mental Health. Researcher Jonathan Meyer and colleagues examined the impact of multiple antipsychotic therapies on changes in systemic inflammation.

According to the December 20 issue of Cardiovascular Device Liability Week, their findings provide evidence that antipsychotic medications like AstraZeneca's Seroquel increase the levels of inflammation markers.

"This analysis provides the most compelling evidence to date that differences in antipsychotic metabolic liability are also seen with markers of systemic inflammation," explained Dr. Meyer. "It also provides an impetus for monitoring cardiovascular risk markers in antipsychotic treated patients," he said.

The markers implicated include C-reactive protein, E-selectin and intercellular adhesion molecular-1 (ICAM-1). Increased levels of C-reactive protein in particular are associated with increased risk for the development or progression of heart disease and stroke.

Dr. John Krystal is the editor of Biological Psychiatry, which published the report. "Doctors always try to balance the benefits and the risks associated with medications when making the decision to prescribe a particular medication to a particular patient," Dr. Krystal said. "The more information that we have regarding the medical consequences of prescribing particular medications, the better the prescribing decisions can be."

It is important to note that the report does not provide direct evidence linking the antipsychotic medications to the disorders studied. Yet as Dr. Krystal says, "It is helpful to know that antipsychotic medications may contribute to inflammatory processes in the body and that these medications differ somewhat in producing this effect."

Researchers were aware that different antipsychotics have different effects on clinical measures associated with cardiovascular risk—namely weight, lipids and glucose. Systemic inflammation has recently emerged as an important marker of cardiovascular risk. However the effects of antipsychotics on inflammatory markers in the blood have not been extensively studied until now.

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