This section highlights key information on cardiometabolic risks and conditions that patients with schizophrenia and bipolar disorder experience in their lifetime, along with the accompanying economic burden of cardiometabolic health disorders
  • Patients with bipolar disorder have a 1.5- to 2.5-fold greater risk for cardiovascular mortality1
  • In a recent meta-analysis, 37% of patients with bipolar disorder had metabolic syndrome, a key contributor to increased risk for cardiovascular mortality2

  • A retrospective cohort study of Medi-Cal fee-for-service beneficiaries (N = 6561) examined pharmacy and medical claims data to characterize the use of atypical antipsychotics, potential adverse metabolic effects, and rates of metabolic monitoring and found that 67% of patients taking one atypical antipsychotic (n = 5203) had ≥1 comorbid cardiometabolic condition3
  • Rates of concomitant treatment were low at 15% for statins, 11% for angiotensin-converting enzyme inhibitors, and 8% for metformin3
  • Weight gain, type 2 diabetes, and dyslipidemia are known adverse effects of atypical antipsychotics
  • The prevalence of these metabolic side effects varies considerably between agents4-6
  • In a retrospective, observational study based on an analysis of administrative data from >700 hospitals and >50 million discharges since 2000, the following outcomes were reported7
  • For patients with bipolar disorder, each additional cardiometabolic comorbidity was associated with a 12.3% increase in medical costs, a 26.6% increase in pharmacy costs, and a 13.4% increase in total costs7

Dollar figures reflect the costs to the hospital to deliver care in 2014 dollars.
Total costs included direct medical and pharmacy costs for patients with schizophrenia (n = 57,506) and patients with bipolar disorder (n = 124,803).


References: 1. Goldstein BI, et al. Bipolar Disord. 2009;11(6):657-662. 2. Vancampfort D, et al. Am J Psychiatry. 2013;170(3):265-274. 3. Medi-Cal. Clinical Review: Atypical Antipsychotics and Adverse Metabolic Effects. 2016. 4. Chong JWX, et al. Ment Health Clin [Internet]. 2016;6(4):178-184. 5. Murray R, et al. Ther Adv Psychopharmacol. 2017;7(1 Suppl):1-14. 6. De Hert M, et al. Schizophr Res. 2008;101(1-3):295-303. 7. Correll CU, et al. Ann Gen Psychiatry. 2017;16:9.