TY  - JOUR
AU  - Milano, Walter
AU  - Campanile, Roberta
AU  - Marchese, Magda
AU  - Milano, Maria Francesca
AU  - Ragozino, Ludovica
AU  - Saetta, Bianca Maria
AU  - Capasso, Anna
PY  - 2026
DA  - 2026/04/09
TI  - Linking Brain, Hormones, and Metabolism: Pathophysiology and Treatment of Antipsychotic-Induced Cardiometabolic Side Effects
JO  - OBM Neurobiology
SP  - 330
VL  - 10
IS  - 02
AB  - This narrative review explores the pathophysiological consequences, neuroendocrine processes, and treatment approaches aimed at reducing the cardiometabolic adverse effects linked to antipsychotic medications; in particular, it highlights recent mechanistic advances in receptor-mediated metabolic dysregulation and emerging therapeutic implications. Schizophrenia, which is a long-term and debilitating disorder, correlates with a substantially shorter life expectancy (15-20 years less than that of the general populace) and elevated all-cause mortality rates. This underscores that psychotic disorders are systemic illnesses involving various physiological systems. Antipsychotics play a crucial role in the treatment of schizophrenia; however, their use can lead to serious side effects, including cardiometabolic dysfunction and metabolic syndrome (MetS). These complications elevate the risk of obesity, diabetes, and dyslipidemia. The underlying mechanisms contributing to these side effects are complex and multifaceted, involving interactions with various receptors, such as D2, H1, M3, and 5-HT2C, as well as influences from gut microbiota, neurohormonal pathways, and genetic predispositions. Furthermore, individual patient characteristics—including lifestyle choices and genetic factors—interact with specific medications, resulting in varied metabolic responses. Weight gain is a common concern for patients receiving treatment, often intensified by unhealthy lifestyle habits that frequently accompany schizophrenia. This rise in weight can adversely affect quality of life, increase the risk of premature mortality, and impede treatment adherence. This article discusses the importance of consistent clinical monitoring, comprehensive patient evaluations, and tailored interventions to effectively balance the therapeutic benefits of antipsychotics with the necessity of managing metabolic risks. It examines both pharmacological and non-pharmacological strategies to improve treatment tolerability and mitigate cardiometabolic complications for individuals with psychotic disorders.
SN  - 2573-4407
UR  - https://doi.org/10.21926/obm.neurobiol.2602330
DO  - 10.21926/obm.neurobiol.2602330
ID  - Milano2026
ER  -