Introduction: Antipsychotic medications, particularly second-generation antipsychotics (SGAs), are central in the treatment of schizophrenia and other psychiatric disorders. However, their use has been strongly associated with metabolic side effects that increase cardiovascular and endocrine risk. The growing burden of antipsychotic-induced metabolic syndrome necessitates proactive strategies to mitigate harm without compromising psychiatric stability. Objective: This review aims to examine the pathophysiology, risk factors, and clinical strategies for the prevention and management of metabolic syndrome in patients using antipsychotic medications. It emphasizes early identification, monitoring, pharmacologic interventions, and lifestyle-based approaches. Methods: A narrative literature review was conducted using five major databases to identify recent publications addressing metabolic syndrome related to antipsychotic use. Studies examining pharmacologic, behavioral, and combined management strategies were prioritized. Inclusion criteria focused on adult populations under long-term antipsychotic therapy. Results and Discussion: Evidence highlights the importance of individualized antipsychotic selection, baseline metabolic screening, and periodic monitoring. Interventions such as metformin, GLP-1 receptor agonists, and structured weight management programs have shown efficacy. Early switching to antipsychotics with lower metabolic risk may also be beneficial in selected patients. Conclusion: Preventing and managing antipsychotic-induced metabolic syndrome requires a multidisciplinary, proactive approach tailored to each patient's psychiatric and physical health. Psychiatric care must evolve to include rigorous metabolic surveillance and evidence-based interventions.
Simionato et al. (2025) studied this question.