Physical Health in Schizophrenia and Role of Clinical Pharmacist: A Narrative Review

Abstract

Schizophrenia is a complex psychiatric disease with an unknown aetiology affecting the biological functions of the brain. It is a psychiatric condition affecting both genders irrespective of race, social class and residential status. Globally lifetime of disease is 0.4%, with a 2.5% mortality rate. Schizophrenic patients die at a young age, about 15-20 years earlier than the general population. Premature death in schizophrenic patients is mainly due to physical illness in the form of cardiovascular and metabolic diseases. Seventy-five percent of patients with a diagnosis of schizophrenia exhibit a minimum of one physical illness and it is more complicated if symptoms are severe. Long-term drug therapy is an eminent risk factor for developing physical illnesses. There is no known cure for schizophrenia; thus, it requires lifelong treatment with antipsychotics. Second-Generation Antipsychotics (SGAs), except clozapine are the first-line drugs for treating schizophrenia. These agents are likely to develop cardiovascular and metabolic side effects like hypertension, hyperlipidemia, weight gain, diabetes mellitus and obesity. Another contributing factor is a sedentary lifestyle. Ignoring these factors while undergoing treatment may result in increased burden, decreased quality of life and shorter life expectancy. Clinical pharmacists have a vital role in managing these patients through proper counselling and medication monitoring for better control of the illness.

Keywords: Schizophrenia; Physical illness; Cardiovascular diseases; Metabolic diseases; Clinical pharmacist