Since the increased use of clozapine for schizophrenia, beginning in 1989, followed in temporal order, by the introduction of other atypical antipsychotic drugs (APDs), e.g. risperidone, olanzapine, quetiapine, ziprasidone and aripiprazole, there has been ever-increasing interest in the effect of these antipsychotics on: (1) body mass index (BMI) and related measures of adiposity; (2) blood glucose and related measures of insulin sensitivity, including the development of type II diabetes mellitus (DM); and (3) hyperlipidaemia. Clinicians who prescribe these drugs have become particularly concerned with increasing rates of obesity and type II DM, the most immediately evident, short-term effects of possible adverse metabolic effects of these agents. At least in the USA, these metabolic effects must be evaluated in the context of the increasing BMI of the population in general, and life-style, economic, and general medical care issues, which may be contributory in patients with schizophrenia or bipolar disorder, for whom these medications are now the mainstay of treatment, having displaced the typical neuroleptic drugs in most western countries.
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