Diabetes mellitus association with chronic use of atypical antipsychotics

Abstract

Abstract Antipsychotic agents are currently considered as the main pharmacological treatment that helps the maintenance management of acute schizophrenia and other mental disorders. These drugs are classified into two groups: First-generation antipsychotics (FGAs) or typical antipsychotics, and Second-generation antipsychotics (SGAs) also known as atypical antipsychotics (AAP). In relation to the use of typical antipsychotics, some relevant adverse effects have been described, especially in terms of extrapyramidal side effects (EPS), which has downgraded their use and encourages the treatment of atypical antipsychotics (AAP) due to the adequate clinical effectiveness demonstrated so far in the practice. However, these drugs have been associated with different metabolic alterations such as the increased risk of suffering from diabetes; thus, several etiopathogenic mechanisms have been proposed. In this narrative review, we seek to present an updated summary of the literature of the last five years about the use of atypical antipsychotics and type 2 diabetes mellitus. Here it has been emphasized the different hypotheses reported so far that involve weight gain and different effects mediated by hormones, neurotransmitter receptors, and neuropeptides that impact on the genesis of hyperglycemia and insulin resistance states.