Clinical Guidance: High Rate of Metabolic Syndrome in Bipolar Disorder
The cluster of cardiovascular and diabetes risk factors known as metabolic syndrome is twice as common among patients with bipolar disorder as among the general population. Antipsychotic medication and greater age further increase the rate. Vancampfort et al. (CME, p. 265) recommend multiple measurements of waist circumference or body mass index, blood pressure, and fasting levels of glucose, lipids, and cholesterol during the first year of treatment. Patients with risk factors should be encouraged to exercise, make dietary changes, and stop smoking. If lifestyle interventions do not succeed, switching to a lower-risk medication or adding one that reduces weight or metabolic abnormalities may be indicated.