{"id":3661,"date":"2020-12-19T15:18:36","date_gmt":"2020-12-19T15:18:36","guid":{"rendered":"https:\/\/curesz.org\/?p=3661"},"modified":"2023-11-15T15:11:20","modified_gmt":"2023-11-15T20:11:20","slug":"comorbidities-in-schizophrenia-a-hidden-medical-emergency","status":"publish","type":"post","link":"https:\/\/curesz.org\/he\/2020\/12\/19\/comorbidities-in-schizophrenia-a-hidden-medical-emergency\/","title":{"rendered":"\u05de\u05d7\u05dc\u05d5\u05ea \u05e0\u05dc\u05d5\u05d5\u05ea \u05d1\u05e1\u05db\u05d9\u05d6\u05d5\u05e4\u05e8\u05e0\u05d9\u05d4: \u05de\u05e6\u05d1 \u05d7\u05d9\u05e8\u05d5\u05dd \u05e8\u05e4\u05d5\u05d0\u05d9 \u05e0\u05e1\u05ea\u05e8"},"content":{"rendered":"
\"\"

\u05d3"\u05e8 \u05e7\u05e8\u05d9\u05d9\u05d2 \u05e6'\u05e4\u05e7\u05d4, \u05d7\u05d1\u05e8, \u05de\u05d5\u05e2\u05e6\u05ea \u05d4\u05de\u05e0\u05d4\u05dc\u05d9\u05dd, \u05e7\u05e8\u05df CURESZ, \u05e4\u05e1\u05d9\u05db\u05d9\u05d0\u05d8\u05e8 \u05e4\u05e8\u05d8\u05d9 \u05d5\u05e2\u05d5\u05d6\u05e8 \u05e4\u05e8\u05d5\u05e4\u05e1\u05d5\u05e8 \u05dc\u05e4\u05e1\u05d9\u05db\u05d9\u05d0\u05d8\u05e8\u05d9\u05d4, \u05d1\u05d9\u05ea \u05d4\u05e1\u05e4\u05e8 \u05dc\u05e8\u05e4\u05d5\u05d0\u05d4 \u05e9\u05dc \u05d0\u05d5\u05e0\u05d9\u05d1\u05e8\u05e1\u05d9\u05d8\u05ea \u05e6\u05e4\u05d5\u05df \u05e7\u05e8\u05d5\u05dc\u05d9\u05d9\u05e0\u05d4<\/p><\/div>\n

Why try to improve someone’s life psychiatrically if we let them die from cardiovascular disease 10-20 years earlier than people without serious mental illness? <\/strong>My psychiatry training program maintained that one is \u201ca physician first, and a psychiatrist second.\u201d<\/em> Therefore, I have increasingly asked myself this question over the past several years. In addition to being a severe brain disease, schizophrenia is also associated with a greater risk of many other physical disorders, referred to as comorbidities. Common comorbidities include obesity, cardiovascular and metabolic disease (e.g., diabetes or high cholesterol), respiratory illnesses, infectious diseases, and many others disorders.<\/p>\n

\u05dc\u05d0\u05e0\u05e9\u05d9\u05dd \u05e2\u05dd \u05e1\u05db\u05d9\u05d6\u05d5\u05e4\u05e8\u05e0\u05d9\u05d4 \u05d9\u05e9 \u05d9\u05d5\u05ea\u05e8 \u05de\u05db\u05e4\u05d5\u05dc \u05de\u05e9\u05d9\u05e2\u05d5\u05e8 \u05d4\u05ea\u05de\u05d5\u05ea\u05d4, \u05d5\u05ea\u05d5\u05d7\u05dc\u05ea \u05d4\u05d7\u05d9\u05d9\u05dd \u05de\u05e6\u05d8\u05de\u05e6\u05de\u05ea \u05d1-10-25 \u05e9\u05e0\u05d9\u05dd \u05d1\u05d4\u05e9\u05d5\u05d5\u05d0\u05d4 \u05dc\u05d0\u05d5\u05db\u05dc\u05d5\u05e1\u05d9\u05d9\u05d4 \u05d4\u05db\u05dc\u05dc\u05d9\u05ea (1). \u05d1\u05e2\u05d5\u05d3 \u05e9\u05d7\u05dc\u05e7 \u05de\u05d4\u05d4\u05d1\u05d3\u05dc \u05d4\u05d6\u05d4 \u05d9\u05db\u05d5\u05dc \u05dc\u05e0\u05d1\u05d5\u05e2 \u05de\u05d4\u05e1\u05d9\u05db\u05d5\u05df \u05d4\u05d2\u05d1\u05d5\u05d4 \u05d1\u05d4\u05e8\u05d1\u05d4 \u05dc\u05d4\u05ea\u05d0\u05d1\u05d3\u05d5\u05ea (\u05e4\u05d9 12 \u05e2\u05d3 170 \u05de\u05d4\u05d0\u05d5\u05db\u05dc\u05d5\u05e1\u05d9\u05d9\u05d4 \u05d4\u05db\u05dc\u05dc\u05d9\u05ea), \u05de\u05e1\u05e4\u05e8 \u05de\u05e7\u05e8\u05d9 \u05d4\u05de\u05d5\u05d5\u05ea \u05d4\u05e2\u05d5\u05d3\u05e4\u05d9\u05dd \u05de\u05de\u05d7\u05dc\u05d5\u05ea \u05dc\u05d1 \u05d5\u05db\u05dc\u05d9 \u05d3\u05dd \u05d1\u05dc\u05d1\u05d3 \u05e2\u05d5\u05dc\u05d4 \u05e2\u05dc \u05de\u05e1\u05e4\u05e8\u05dd \u05e9\u05dc \u05d0\u05e0\u05e9\u05d9\u05dd \u05e2\u05dd \u05e1\u05db\u05d9\u05d6\u05d5\u05e4\u05e8\u05e0\u05d9\u05d4 \u05db\u05ea\u05d5\u05e6\u05d0\u05d4 \u05de\u05d4\u05ea\u05d0\u05d1\u05d3\u05d5\u05ea (2,3). \u05d0\u05d5\u05dc\u05d9 \u05d4\u05d2\u05d9\u05e2 \u05d4\u05d6\u05de\u05df \u05dc\u05d4\u05ea\u05d7\u05d9\u05dc \u05dc\u05d7\u05e9\u05d5\u05d1 \u05e2\u05dc \u05de\u05d7\u05dc\u05d5\u05ea \u05e0\u05dc\u05d5\u05d5\u05ea \u05db\u05e2\u05dc \u05de\u05e6\u05d1 \u05d7\u05d9\u05e8\u05d5\u05dd \u05db\u05de\u05d5 \u05e9\u05d0\u05e0\u05d7\u05e0\u05d5 \u05e2\u05d5\u05e9\u05d9\u05dd \u05d4\u05ea\u05d0\u05d1\u05d3\u05d5\u05ea!<\/strong><\/p>\n

\u05d0\u05e0\u05d7\u05e0\u05d5 \u05e6\u05e8\u05d9\u05db\u05d9\u05dd \u05d2\u05dd \u05dc\u05e7\u05d7\u05ea \u05d1\u05d7\u05e9\u05d1\u05d5\u05df \u05e9\u05d0\u05e0\u05e9\u05d9\u05dd \u05e8\u05d1\u05d9\u05dd \u05e2\u05dd \u05e1\u05db\u05d9\u05d6\u05d5\u05e4\u05e8\u05e0\u05d9\u05d4 \u05e0\u05de\u05e6\u05d0\u05d9\u05dd \u05d1\u05e0\u05d7\u05d9\u05ea\u05d5\u05ea \u05e1\u05d5\u05e6\u05d9\u05d5-\u05d0\u05e7\u05d5\u05e0\u05d5\u05de\u05d9\u05ea. \u05d6\u05d4 \u05de\u05d2\u05d3\u05d9\u05dc \u05d0\u05ea \u05d4\u05e1\u05d1\u05d9\u05e8\u05d5\u05ea \u05dc\u05e1\u05d9\u05db\u05d5\u05e0\u05d9\u05dd \u05d1\u05d0\u05d5\u05e8\u05d7 \u05d7\u05d9\u05d9\u05dd \u05db\u05de\u05d5 \u05e2\u05d9\u05e9\u05d5\u05df, \u05d7\u05d5\u05e1\u05e8 \u05e4\u05e2\u05d9\u05dc\u05d5\u05ea \u05d2\u05d5\u05e4\u05e0\u05d9\u05ea \u05d5\u05ea\u05d6\u05d5\u05e0\u05d4 \u05dc\u05d0 \u05d1\u05e8\u05d9\u05d0\u05d4. \u05d4\u05dd \u05e2\u05e9\u05d5\u05d9\u05d9\u05dd \u05d2\u05dd \u05dc\u05d4\u05d9\u05e2\u05d3\u05e8 \u05d2\u05d9\u05e9\u05d4 \u05dc\u05d8\u05d9\u05e4\u05d5\u05dc \u05e8\u05e4\u05d5\u05d0\u05d9 \u05de\u05d5\u05e0\u05e2 \u05e7\u05d1\u05d5\u05e2 \u05e2\u05e7\u05d1 \u05de\u05e2\u05e8\u05db\u05ea \u05e8\u05e4\u05d5\u05d0\u05d9\u05ea \u05e2\u05de\u05d5\u05e1\u05d4, \u05d1\u05e2\u05d9\u05d5\u05ea \u05d1\u05d9\u05d8\u05d5\u05d7 \u05d0\u05d5 \u05d1\u05e2\u05d9\u05d5\u05ea \u05ea\u05d7\u05d1\u05d5\u05e8\u05d4.<\/p>\n

This is a powder keg of risk factors and on top of that, most antipsychotic medications have some degree of weight gain or other metabolic problems as potential side effects.<\/p>\n

\n

"\u05dc\u05d0\u05e0\u05e9\u05d9\u05dd \u05e9\u05d7\u05d9\u05d9\u05dd \u05e2\u05dd \u05e1\u05db\u05d9\u05d6\u05d5\u05e4\u05e8\u05e0\u05d9\u05d4 \u05de\u05d2\u05d9\u05e2 \u05d7\u05d9\u05d9\u05dd \u05e2\u05dd \u05e9\u05e0\u05d9\u05d4\u05dd
\n\u05d9\u05e6\u05d9\u05d1\u05d5\u05ea \u05e0\u05e4\u05e9\u05d9\u05ea \u05d5\u05d1\u05e8\u05d9\u05d0\u05d5\u05ea \u05d2\u05d5\u05e4\u05e0\u05d9\u05ea \u05d8\u05d5\u05d1\u05d4".<\/h2>\n<\/blockquote>\n

Psychiatrists have a significant challenge in figuring out how to proceed when these complications develop. A common strategy is to switch the person to an antipsychotic medication with a lower risk, such as ziprasidone, lurasidone, cariprazine, or lumateperone. However, the antipsychotic medications that carry the highest risk for these obstacles also have some of the best reputations for efficacy, including clozapine and olanzapine. Antipsychotic medications are usually not interchangeable when it comes to maintaining treatment response, which puts the person at risk of relapse.<\/p>\n

Finding the balance between benefits and side effects can be like walking the razor\u2019s edge at times. Both are important, but which one should we prioritize? The National Institute of Mental Health performed a large clinical trial to answer questions like this. The CATIE study took a more \u201creal-world\u201d approach by comparing the length of time people with schizophrenia continued to take the antipsychotic medications they were on. This approach is based on the theory that if someone keeps taking a medication over the long run, the benefits must exceed the drawbacks. People stayed on olanzapine longer than the other antipsychotic medications tested despite having the highest amount of weight and metabolic side effects, presumably because of its superior efficacy (4). CATIE also highlighted the unfortunate lack of medical care for people with schizophrenia. Participants in clinical trials generally get a higher level of care than in the general community, but in the CATIE study, 30% of participants with diabetes, 62% with high blood pressure, and 88% with high cholesterol were not receiving any treatment for these conditions (5).<\/p>\n

The saying that \u201can ounce of prevention is worth a pound of cure\u201d is common for a reason. It\u2019s much harder to lose weight than it is to prevent weight gain from happening, so waiting to react until after weight gain occurs isn\u2019t usually a good strategy. As such, it\u2019s becoming increasingly common for psychiatrists to prescribe metformin (also used in type 2 diabetes) at the start of treatment with an antipsychotic to reduce the risk of weight gain proactively. Similarly, a medication was approved by the FDA in 2021 containing the highly effective antipsychotic olanzapine with a medication that reduces weight gain potential, samidorphan, in a single pill.<\/p>\n

\u05d0\u05d5\u05dc\u05d9 \u05d6\u05d4 \u05dc\u05d0 \u05de\u05d5\u05d1\u05df \u05de\u05d0\u05dc\u05d9\u05d5 \u05dc\u05d7\u05e9\u05d5\u05d1 \u05e2\u05dc \u05d1\u05e8\u05d9\u05d0\u05d5\u05ea \u05d2\u05d5\u05e4\u05e0\u05d9\u05ea \u05db\u05d7\u05dc\u05e7 \u05de\u05ea\u05d5\u05db\u05e0\u05d9\u05ea \u05d4\u05d8\u05d9\u05e4\u05d5\u05dc \u05d4\u05e4\u05e1\u05d9\u05db\u05d9\u05d0\u05d8\u05e8\u05d9, \u05d0\u05d1\u05dc \u05d6\u05d4 \u05d7\u05d9\u05d5\u05e0\u05d9 \u05dc\u05e2\u05e9\u05d5\u05ea \u05d6\u05d0\u05ea.<\/strong> \u05ea\u05d7\u05d9\u05dc\u05ea \u05d4\u05e2\u05d1\u05d5\u05d3\u05d4 \u05e2\u05e9\u05d5\u05d9\u05d4 \u05dc\u05d4\u05d9\u05e8\u05d0\u05d5\u05ea \u05de\u05db\u05e8\u05d9\u05e2\u05d4, \u05d0\u05d6 \u05d4\u05e0\u05d4 \u05db\u05de\u05d4 \u05e4\u05e8\u05d9\u05d8\u05d9 \u05e4\u05e2\u05d5\u05dc\u05d4 \u05e9\u05d9\u05e2\u05d6\u05e8\u05d5 \u05dc\u05d0\u05e0\u05e9\u05d9\u05dd \u05e2\u05dd \u05e1\u05db\u05d9\u05d6\u05d5\u05e4\u05e8\u05e0\u05d9\u05d4 \u05dc\u05d4\u05d9\u05dc\u05d7\u05dd \u05e0\u05d2\u05d3 \u05d4\u05d0\u05d2\u05e8\u05d4 \u05d4\u05e4\u05d9\u05d6\u05d9\u05ea \u05e9\u05d4\u05d9\u05d0 \u05e2\u05dc\u05d5\u05dc\u05d4 \u05dc\u05d2\u05d1\u05d5\u05ea \u05de\u05d2\u05d5\u05e4\u05dd:<\/p>\n

1) Talk to your psychiatrist about your physical health and ways to help you support it.<\/p>\n

2) \u05e2\u05e7\u05d5\u05d1 \u05d0\u05d7\u05e8 \u05d4\u05e9\u05d9\u05e0\u05d5\u05d9\u05d9\u05dd \u05d1\u05de\u05e9\u05e7\u05dc \u05d5\u05d1\u05d2\u05d5\u05d3\u05dc \u05d4\u05de\u05db\u05e0\u05e1\u05d9\u05d9\u05dd \u05e9\u05dc\u05da, \u05de\u05db\u05d9\u05d5\u05d5\u05df \u05e9\u05de\u05d9\u05d3\u05ea \u05d4\u05de\u05d5\u05ea\u05e0\u05d9\u05d9\u05dd \u05d4\u05d9\u05d0 \u05de\u05e0\u05d1\u05d0 \u05e9\u05d9\u05de\u05d5\u05e9\u05d9 \u05dc\u05ea\u05e1\u05de\u05d5\u05e0\u05ea \u05de\u05d8\u05d1\u05d5\u05dc\u05d9\u05ea.<\/p>\n

3) \u05d4\u05e7\u05e4\u05d9\u05d3\u05d5 \u05dc\u05e2\u05d1\u05d5\u05e8 \u05d1\u05d3\u05d9\u05e7\u05d5\u05ea \u05e7\u05d1\u05d5\u05e2\u05d5\u05ea \u05d0\u05e6\u05dc \u05e8\u05d5\u05e4\u05d0 \u05e8\u05d0\u05e9\u05d5\u05e0\u05d9.<\/p>\n

People living with schizophrenia deserve a life with both mental stability and good physical health. Let’s make fighting for the best of both worlds your New Year\u2019s Resolution!<\/p>\n

\u05d4\u05e4\u05e0\u05d9\u05d5\u05ea:<\/p>\n

    \n
  1. \u05d3\u05e3 \u05de\u05d9\u05d3\u05e2 \u05e9\u05dc \u05d0\u05e8\u05d2\u05d5\u05df \u05d4\u05d1\u05e8\u05d9\u05d0\u05d5\u05ea \u05d4\u05e2\u05d5\u05dc\u05de\u05d9 \u05dc\u05d4\u05e4\u05e8\u05e2\u05d5\u05ea \u05e0\u05e4\u05e9\u05d9\u05d5\u05ea. https:\/\/www.who.int\/mental_health\/management\/info_sheet.pdf<\/a><\/li>\n
  2. Zaheer, Juveria, et al. "\u05de\u05e0\u05d1\u05d0\u05d9\u05dd \u05e9\u05dc \u05d4\u05ea\u05d0\u05d1\u05d3\u05d5\u05ea \u05d1\u05d6\u05de\u05df \u05d4\u05d0\u05d1\u05d7\u05d5\u05df \u05d1\u05d4\u05e4\u05e8\u05e2\u05ea \u05e1\u05e4\u05e7\u05d8\u05e8\u05d5\u05dd \u05e1\u05db\u05d9\u05d6\u05d5\u05e4\u05e8\u05e0\u05d9\u05d4: \u05de\u05d7\u05e7\u05e8 \u05d0\u05d5\u05db\u05dc\u05d5\u05e1\u05d9\u05d9\u05d4 \u05db\u05d5\u05dc\u05dc \u05e9\u05dc 20 \u05e9\u05e0\u05d4 \u05d1\u05d0\u05d5\u05e0\u05d8\u05e8\u05d9\u05d5, \u05e7\u05e0\u05d3\u05d4." \u05d7\u05e7\u05e8 \u05e1\u05db\u05d9\u05d6\u05d5\u05e4\u05e8\u05e0\u05d9\u05d4 (2020).<\/li>\n
  3. \u00d6sby, Urban, et al. "\u05ea\u05de\u05d5\u05ea\u05d4 \u05d5\u05e1\u05d9\u05d1\u05d5\u05ea \u05de\u05d5\u05d5\u05ea \u05d1\u05e1\u05db\u05d9\u05d6\u05d5\u05e4\u05e8\u05e0\u05d9\u05d4 \u05d1\u05de\u05d7\u05d5\u05d6 \u05e9\u05d8\u05d5\u05e7\u05d4\u05d5\u05dc\u05dd, \u05e9\u05d5\u05d5\u05d3\u05d9\u05d4." \u05de\u05d7\u05e7\u05e8 \u05e1\u05db\u05d9\u05d6\u05d5\u05e4\u05e8\u05e0\u05d9\u05d4 45.1-2 (2000): 21-28<\/li>\n
  4. \u05dc\u05d9\u05d1\u05e8\u05de\u05df, \u05d2'\u05e4\u05e8\u05d9 \u05d0' \u05d5\u05e2\u05d5\u05d3. "\u05d4\u05d9\u05e2\u05d9\u05dc\u05d5\u05ea \u05e9\u05dc \u05ea\u05e8\u05d5\u05e4\u05d5\u05ea \u05d0\u05e0\u05d8\u05d9 \u05e4\u05e1\u05d9\u05db\u05d5\u05d8\u05d9\u05d5\u05ea \u05d1\u05d7\u05d5\u05dc\u05d9\u05dd \u05e2\u05dd \u05e1\u05db\u05d9\u05d6\u05d5\u05e4\u05e8\u05e0\u05d9\u05d4 \u05db\u05e8\u05d5\u05e0\u05d9\u05ea."\u00a0\u05e0\u05d9\u05d5 \u05d0\u05d9\u05e0\u05d2\u05dc\u05e0\u05d3 \u05db\u05ea\u05d1 \u05e2\u05ea \u05dc\u05e8\u05e4\u05d5\u05d0\u05d4<\/em>353.12 (2005): 1209-1223.<\/li>\n
  5. \u05e0\u05e1\u05e8\u05d0\u05dc\u05dc\u05d4, \u05d4\u05e0\u05e8\u05d9 \u05d0' \u05d5\u05e2\u05d5\u05d3. "\u05e9\u05d9\u05e2\u05d5\u05e8\u05d9\u05dd \u05e0\u05de\u05d5\u05db\u05d9\u05dd \u05e9\u05dc \u05d8\u05d9\u05e4\u05d5\u05dc \u05dc\u05d9\u05ea\u05e8 \u05dc\u05d7\u05e5 \u05d3\u05dd, \u05d3\u05d9\u05e1\u05dc\u05d9\u05e4\u05d9\u05d3\u05de\u05d9\u05d4 \u05d5\u05e1\u05d5\u05db\u05e8\u05ea \u05d1\u05e1\u05db\u05d9\u05d6\u05d5\u05e4\u05e8\u05e0\u05d9\u05d4: \u05e0\u05ea\u05d5\u05e0\u05d9\u05dd \u05de\u05de\u05d3\u05d2\u05dd \u05e0\u05d9\u05e1\u05d5\u05d9 \u05d4\u05e1\u05db\u05d9\u05d6\u05d5\u05e4\u05e8\u05e0\u05d9\u05d4 \u05e9\u05dc CATIE \u05d1\u05e7\u05d5 \u05d4\u05d1\u05e1\u05d9\u05e1." \u05de\u05d7\u05e7\u05e8 \u05e1\u05db\u05d9\u05d6\u05d5\u05e4\u05e8\u05e0\u05d9\u05d4 86.1-3 (2006): 15-22.<\/li>\n<\/ol>\n

     <\/p>","protected":false},"excerpt":{"rendered":"

    Why try to improve someone’s life psychiatrically if we let […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-3661","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"acf":[],"yoast_head":"\nComorbidities in Schizophrenia: A Hidden Medical Emergency - CURESZ Foundation<\/title>\n<meta name=\"description\" content=\"What\u2019s the use of saving someone\u2019s life psychiatrically if we let them die over a decade earlier from cardiovascular disease?\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/curesz.org\/he\/2020\/12\/19\/comorbidities-in-schizophrenia-a-hidden-medical-emergency\/\" \/>\n<meta property=\"og:locale\" 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