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Pharmacological Approaches to Minimizing Cardiometabolic Side Effects of Mood Stabilizing Medications

  • Bipolar and Other Mood Disorders (B Goldstein and D Hafeman, Section Editor)
  • Published:
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Abstract

Purpose of review

Purpose of review The aim of this study is to review pharmacological approaches to minimizing the cardiometabolic side effects of mood stabilizing medications.

Recent findings

Recent findings The majority of mood stabilizing medications have significant and problematic cardiometabolic side effects. Several newer mood stabilizing medications, such as aripiprazole, lurasidone, ziprasidone, cariprazine, and brexpiprazole, have been shown to have decreased cardiometabolic risk compared to several older mood stabilizing treatments such as valproate, lithium, quetiapine, olanzapine, and clozapine. Additionally, several weight loss medications have now been shown to ameliorate cardiometabolic side effects.

Summary

Summary Mood stabilizing medications with less cardiometabolic effects should be prioritized in the treatment of bipolar disorder. In addition to lifestyle modification and prioritizing metabolically neutral treatments, several medications (e.g., metformin, liraglutide, topiramate, and melatonin) have been shown to improve cardiometabolic profiles of patients treated with second-generation antipsychotics. If needed, these weight loss agents may be cautiously prescribed to help ameliorate cardiometabolic side effects.

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Authors and Affiliations

  1. Mood Disorder Psychopharmacology Unit, University Health Network, Department of Psychiatry and Pharmacology, University of Toronto, 399 Bathurst Street, MP 9-325, Toronto, ON, M5T 2S8, Canada

    Joshua D. Rosenblat MD & Roger S. McIntyre MD

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Correspondence to Roger S. McIntyre MD.

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Dr. McIntyre reports personal speaker/consultation fees from Shire, Purdue, Otsuka, Janssen-Ortho, Lundbeck, Pfizer, Neurocrine, Neuralstem, Sunovion, Takeda & Allergan and grants from Lundbeck, Shire, Purdue & Allergan, outside the submitted work. Joshua Rosenblat declares that he has no conflicts of interest.

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Rosenblat, J.D., McIntyre, R.S. Pharmacological Approaches to Minimizing Cardiometabolic Side Effects of Mood Stabilizing Medications. Curr Treat Options Psych 4, 319–332 (2017). https://doi.org/10.1007/s40501-017-0131-z

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