Doctors must not forget about the physical health of people with serious mental health disorders who take antipsychotic drugs, experts warn.
Background
The authors of an editorial in The Lancet noted that patients with severe mental illness live an average of 16 years less than people in the general population. Heart disease, not suicide, is the major cause of death in these patients and antipsychotic drugs are a factor.
A study published recently in the Archives of General Psychiatry found that patients who took an antipsychotic drug gained 11 to 13 pounds within six to eight weeks after they starting taking the drug.
"The combination of antipsychotic side effects with poor diet, physical inactivity, high rates of smoking and other factors associated with psychotic illness, together with socioeconomic deprivation, has a devastating effect on cardiometabolic health, according to the editorial.
Mental Vs. Physical Health
"If existing antipsychotics are here to stay—at least for the foreseeable future—what can be done to ameliorate their effects and improve patients' cardiometabolic health?" the authors asked.
Sole responsibility for safeguarding the physical health of patients with serious mental health conditions often falls to primary care providers, but mental health teams need to take an active role in that care, the editorial suggests. For example, a patient's physical health should be assessed when they enter mental health care.
"A lack of training in physical health issues is worrying in psychiatric doctors and nurses alike. In view of the wealth of evidence about the interconnections between mental health, physical health and prescribed medication, postgraduate psychiatric training should prioritize up-to-date knowledge about evidence-based management of cardiometabolic disease," the authors wrote.
They concluded: "Antipsychotic drugs are a clear risk to cardiometabolic health. This risk is, all too often, a necessary one. But the trade-off between mental and physical well-being is one that no patient should be forced to make. The mind-body dichotomy is both outdated and dangerous. The price of good mental health must not be a lifetime of physical illness."
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