In patients with schizophrenia, management of comorbidities and the potential for suicide are important considerations for clinicians, according to Leslie Citrome, MD, MPH, clinical professor, Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, NY, who spoke with MDLinx
here at the American Psychiatric Association’s 2018 Annual Meeting.
The most common comorbidities include alcohol-abuse and substance abuse disorders, said Dr. Citrome. In addition, these patients are more likely to develop metabolic problems, which in turn can be accelerated by treatment with antipsychotic agents.
“If antipsychotics are associated with weight gain for an individual person, for example, they become insulin resistant sooner, and may have problems with their glucose. They may have problems with their lipids, and this increases the risk of cardiovascular disease, heart attack, stroke, and that sort of thing,” he said.
Clinicians should also be concerned about the potential for suicide in these patients, Dr. Citrome added. The FDA has approved clozapine for patients with schizophrenia or schizoaffective disorder who may be suicidal.
“We often forget that that’s one of the indications for clozapine. We usually think of it as just for treatment-resistant schizophrenia but it’s also quite helpful for those who have problems with suicidality,” he noted.