Psychopharmaka-induzierte unerwünschte Wirkungen in der Ernährungstherapie

Metabolic effects of psychotropic drugs are very common - which primarily is the case due to appetite-enhancing and body weight increasing effects. In particular, use of antipsychotics (neuroleptics) and some antidepressants (mirtazapine, lithium, tricyclics) is associated with weight gain. Resulting metabolic changes often are clinically relevant as they may negatively impact cardiovascular morbidity and mortality. Especially in patients receiving antipsychotics, regular checkup should be executed (body weight, blood pressure, blood glucose, cholesterol, hepatic/renal function). A specific metabolic monitoring should be implemented. Drug-specific metabolic side effects can be anticipated and mitigated or prevented by appropriate nutritional and behavioural interventions. Alternatively, the physician should also consider a change in drug, if the side effects impair the quality of life of the patient relevantly. If other measures remain ineffective for weight control, application of orlistat or metformin (off-label) may be tried.