Authors

Alfonso Sevillano-Jiménez1, Lorena Carrascal-Laso2, Ana Belén Romero-Ruíz3

Position

1Graduado en Enfermería. Enfermero Especialista en Enfermería de Salud Mental. Unidad de Salud Mental Comunitaria de Montilla (USMC-Montilla). Unidad de Gestión Clínica (UGC) de Salud Mental. Hospital Universitario Reina Sofía. Córdoba (España)2Licenciada en Medicina. Especialista en Psiquiatría. Servicio de Psiquiatría. Hospital Provincial de Zamora. Complejo Asistencial de Zamora. Zamora (España)3Graduada en Enfermería. UGC de Pediatría. Unidad de Hospitalización y Oncohematología Pediátrica y Trasplantes. Hospital Universitario Reina Sofía. Córdoba (España)

Contact address

Alfonso Sevillano Jiménez. C/ Santa Clara, 1. 23740 Andújar, Jaén (España).

Contact email: alfonso.sevillano.jimenez@gmail.com

Abstract

Objective: to provide evidence about the factors determining iatrogenic metabolic syndrome derived of the use of second-generation antipsychotics.
Methods: a narrative review was conducted between January and February 2020. This entailed bibliographic searches in different databases and platforms: Pubmed, Science Direct, Google Scholar and UpToDate. The following key words were used (MeSH/DeCS): antipsychotic agents (antipsicóticos), atypical antipsychotics (antipsicóticos atípicos), metabolic syndrome (síndrome metabólico), Nursing (enfermería), side effects (efectos adversos), mental health (salud mental). Inclusion criteria: Spanish and English languages, original and full-text publications from the last five years, studies in human beings.
Results: in total, 32 articles were retrieved. Evidence determined that clozapine, olanzapine and paliperidone were the main second-generation antipsychotics contributing to metabolic syndrome. It would be convenient to conduct anthropometric and biochemical monitoring: blood pressure, weight, abdominal perimeter, body mass index (BMI), glucose, HDL and triglycerides. A multimodal treatment approach is needed to prevent metabolic syndrome, as well as an improvement in healthcare education regarding healthy lifestyles, and considering homeostatic polypharmacy. Nursing plays a leading role by using assessment tools focused on pharmacovigilance, sexuality and quality of life.
Conclusions: healthcare policies must be designed according to the expectations and needs of the psychiatric population, promoting healthy lifestyles and psychopharmacological care due to the high cardiovascular risk. Mental Health Nursing becomes a cornerstone for the care, prevention, coordination and community follow-up of iatrogenic metabolic syndrome.

Keywords:

Antipsychotic agents; metabolic syndrome; nursing; second generation antipsychotics

Versión en Español

Título:

Síndrome metabólico iatrogénico derivado del uso de antipsicóticos de segunda generación