Metabolic Syndrome in Patients With Major Depressive Disorder Associated Risk Factors: Page 3 of 3

Metabolic Syndrome in Patients With Major Depressive Disorder Associated Risk Factors: Page 3 of 3

Several recent studies have explored the link between metabolic syndrome, stress, and the hypothalamic-pituitary-adrenal axis.9,19,20 Brown and colleagues21 concluded that elevated cortisol levels are strongly associated with depression and abdominal obesity (and somewhat with diabetes and hypertension), but not with hy­perlipidemia. Thus, among the many factors important in the etiology of metabolic syndrome there may be con­­sid­­erable variability in which metabolic measures are affected as well as variability in the mechanisms of action.

Future research may allow more precise delineation of risks and lead to more clinically useful risk profiles. The criteria for metabolic syndrome continue to evolve, and this debate may point to important areas for new research.3 For example, some metabolic measures may be more important than others in psychiatric patients, and some risks may be negated by appropriate treatment (eg, statins, antihypertensives) or by a change in psychotropics.

The concern about metabolic syndrome should not be limited to patients with a diagnosis of schizophrenia or to those treated with atypical antipsychotics. The presence of even one criterion for metabolic syndrome is of potential concern and may be an early warning signal that can prevent progression to the full syndrome.

Drugs Mentioned in This Article
Carbamazepine (Carbatrol, Tegretol, others)
Divalproex (Epival, Depakote)
Lithium (Eskalith, Lithane, Lithobid)




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