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Effets métaboliques indésirables des antipsychotiques

Metabolic side effects of antipsychotics

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Obésité

Résumé

L’obésité et le syndrome métabolique sont une source majeure de morbidités et mortalité chez les patients prenant au long cours un traitement antipsychotique, et contribuent à la réduction de leur espérance de vie. Plusieurs mécanismes intriqués participent à ces effets néfastes, comprenant à la fois les impacts sur la prise alimentaire et le métabolisme glucido-lipidique. Les effets secondaires métaboliques des antipsychotiques varient de façon significative d’une molécule à l’autre, les deux agents les plus délétères étant l’olanzapine et la clozapine. La compréhension des mécanismes pharmacologiques à l’origine de ces effets secondaires métaboliques demeure essentielle pour la conception de nouveaux agents dépourvus de ces effets délétères. Pour autant, cette recherche ne doit en aucun cas retarder la prise en charge actuelle des patients par des mesures préventives et curatives appropriées.

Abstract

Obesity and metabolic syndrome are a major source of morbidity and mortality in patients receiving long-term antipsychotic treatment, and contribute to reduce their life expectancy. Several intricated mechanisms are involved in these adverse effects, including both the impact on food intake and glucose and lipid metabolism. The metabolic side effects of antipsychotics vary significantly from one molecule to another, the two most deleterious agents being olanzapine and clozapine. Understanding of the pharmacological mechanisms behind these metabolic side effects remains essential for the design of new agents without these deleterious effects. However, this research should not delay the current management of patients with preventive and curative measures.

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  1. Service d’Endocrinologie et Inserm UMR_938, CHU de Saint-Antoine, Université Paris 6, Service d’endocrinologie, Hôpital Saint-Antoine, 184, rue du Faubourg Saint-Antoine, 75012, Paris, France

    B. Fève

  2. Faculté de Médecine, 27, rue de Chaligny, 75012, Paris, France

    B. Fève

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Fève, B. Effets métaboliques indésirables des antipsychotiques. Obes 8, 165–173 (2013). https://doi.org/10.1007/s11690-013-0365-x

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