Schizophrenia bulletin · 2026
Clinical Practice Guideline on the Pharmacological Management of Antipsychotic-Related Dyslipidemia.
СтатьяКлинические рекомендацииНазвание и аннотация: Перевод пока не подготовлен
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Carolan Aoife, Hynes-Ryan Caroline, Bourke Rita, Columb David, Cullen Walter, deFerranti Sarah, Harrington Sophie Mae, Kelleher Ian, Kennedy Cormac, Khoury Michael, Lally John, Lyne John, Norton Michael, O'Connor Karen, O'Connor Patricia, O'Shea Donal, Perry Benjamin, Prendeville Terence, Ryan Cristin, Sadowska Ewa, Shiers David, Siskind Dan, Strawbridge Judith, Tae Haeun, Keating Dolores, O'Donoghue Brian
Аннотация
BACKGROUND: People taking antipsychotic medicines and those with severe mental illness experience elevated cardiovascular risk compared to the general population which is not adequately addressed by existing guidelines. Increases in lipid levels can occur soon after starting antipsychotics but often go untreated. Cumulative exposure to dyslipidemia from childhood, through young adulthood, facilitates atherogenesis. Regression of early lesions is possible; however, plaque progression can be irreversible, leading to sustained long-term cardiovascular risk. Although lipid-lowering therapies are effective at lowering cardiovascular risk, they are underutilized in this population. We have thus developed a clinical practice guideline for the pharmacological management of antipsychotic-related dyslipidemia.
STUDY DESIGN: Using GRADE-ADOLOPMENT methodology, an international, multidisciplinary panel including experts-by-experience, developed a guideline for the pharmacological management of antipsychotic-related dyslipidemia. Literature was reviewed to answer key health questions. Patient important outcomes were identified. An evidence-to-decision framework informed the strength of recommendations and external reviews evaluated the rigor of the methods.
STUDY RESULTS: Seven recommendations were developed on how and when to initiate lipid-lowering therapy based on specific criteria including established cardiovascular disease/high-risk conditions, cardiovascular risk assessment, or lipid parameter thresholds. A guideline algorithm illustrates the recommendations alongside supporting prescribing information.
CONCLUSIONS: This is the first clinical practice guideline for the management of antipsychotic-related dyslipidemia. The inclusion of recommendations for individuals aged 10 years and over represents a significant development. Implementation will be supported by shared decision-making resources including information videos and decision-aids.
STUDY DESIGN: Using GRADE-ADOLOPMENT methodology, an international, multidisciplinary panel including experts-by-experience, developed a guideline for the pharmacological management of antipsychotic-related dyslipidemia. Literature was reviewed to answer key health questions. Patient important outcomes were identified. An evidence-to-decision framework informed the strength of recommendations and external reviews evaluated the rigor of the methods.
STUDY RESULTS: Seven recommendations were developed on how and when to initiate lipid-lowering therapy based on specific criteria including established cardiovascular disease/high-risk conditions, cardiovascular risk assessment, or lipid parameter thresholds. A guideline algorithm illustrates the recommendations alongside supporting prescribing information.
CONCLUSIONS: This is the first clinical practice guideline for the management of antipsychotic-related dyslipidemia. The inclusion of recommendations for individuals aged 10 years and over represents a significant development. Implementation will be supported by shared decision-making resources including information videos and decision-aids.