Patients taking prescribed psychotropic medications, such as antidepressants and mood stabilisers, need better ongoing physical health monitoring and support, according to a new Lancet Commission.
The findings provide an updated and practical guide for healthcare professionals on how to reduce the burden of side effects such as weight gain and diabetes caused by psychotropic medications.
The Lancet Psychiatry Physical Health Commission recommendations include new monitoring and management measures such as a full physical health assessment when treatment is first prescribed, early monitoring such as weight checks within four weeks of commencing treatment.
The need for ongoing tracking of cardiometabolic markers, including blood sugar, cholesterol and blood pressure to prevent conditions such as diabetes and other cardiometabolic conditions is also highlighted.
Lifestyle interventions in mental health care
The report is one of two new papers published by the Lancet Psychiatry Physical Health Commission which look at monitoring the physical health of people prescribed psychotropic medication and lifestyle interventions in mental health care.
The Commission’s first report, published in 2019, provided a blueprint for protecting physical health in people with mental illness, with guidance for health promotion, multidisciplinary clinical care, and future research.
The new work highlights the need for mental health patients to have holistic rather than fragmented health care provision and could lead to improved quality of life for many individuals prescribed psychotropic medications.
Medications, including antipsychotics, mood stabilisers and antidepressants, which are essential in the treatment of many mental health conditions, can cause significant physical side effects that often go unnoticed in routine care.
Psychotropic medication side effects can contribute to diabetes
Many patients taking psychotropic medications put on weight, which contributes to the development of metabolic conditions such as diabetes.
The latest reports warn that the side effects can impact physical health and quality of life, and may trigger some patients to stop taking their medication, compromising the associated benefits of treatment.
The Commission, co-led by experts from King’s College London, the University of Oxford and the University of Queensland, conducted a systematic review of the available evidence, covering 11 key areas of side effects, including metabolic, cardiovascular, renal, sexual and neurological complications.
The report outlines practical steps for healthcare providers, calling for proactive prevention, shared decision-making and better coordination of care to help clinicians act quickly and consistently to protect patients’ physical health.
It also includes feedback from service users, who say that while advice on diet and exercise is common, putting it into practice is often difficult without support. Patients cite barriers such as severe depression and the lethargy or sedation caused by many medications.
Dr Toby Pillinger, academic clinical lecturer at the Institute of Psychiatry, Psychology and Neuroscience at King’s College London, and a senior author for the Commission, said: ‘Psychiatric medications save lives and help people regain stability in their daily lives – but they can also cause serious physical side effects. Too often, these are seen as the cost of treatment, or worse, ignored altogether.
‘This Commission is about saying that patients deserve better. With simple monitoring and timely interventions, we hope to reduce the burden of side effects and improve long-term outcomes.’
A version of this article was originally published by our sister publication Nursing in Practice.
