[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-411334-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-411334-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","antipsychotic-misuse-a-silent-but-growing-public-health-hazard","Antipsychotic Misuse: A Silent but Growing Public Health Hazard","","Antipsychotic drugs play an essential role in treating schizophrenia, bipolar disorder, and other psychiatric illnesses, yet their use is strongly associated with cardiometabolic side effects. These include weight gain, dyslipidemia, glucose intolerance, and elevated cardiovascular morbidity and mortality. The review explains mechanistic pathways involving appetite regulation within the central nervous system, peripheral metabolic changes outside the CNS, and receptor-level interactions. It synthesizes evidence on consequences of therapy, rising inappropriate off-label atypical use, vulnerable populations, and practical monitoring and mitigation strategies, including analysis of recent trends and costs.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/antipsychotic-misuse-a-silent-but-growing-public-health-hazard/411334/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/antipsychotic-misuse-a-silent-but-growing-public-health-hazard/411334.png","ImageObject",300,407,{"name":42,"@type":43},"Stanley","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-04","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",10,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What cardiometabolic side effects are linked to antipsychotic use?","Question",{"text":63,"@type":64},"Antipsychotic use is associated with weight gain, dyslipidemia, glucose intolerance, and higher cardiovascular morbidity and mortality.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How does off-label prescribing of antipsychotics relate to evidence quality?",{"text":68,"@type":64},"A small number of off-label uses have modest empirical support, while many other applications lack convincing evidence, despite widespread prescribing for conditions like insomnia and anxiety.",{"name":70,"@type":61,"acceptedAnswer":71},"What trends in off-label atypical antipsychotic use are highlighted?",{"text":72,"@type":64},"Visits involving off-label use with uncertain evidence increased substantially for atypical agents from 1995 to 2008, with a nearly tenfold escalation in utilization.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},411334,1790674513,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":55,"slug":125},"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":139,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145,"preview_page_count":4},2336477405376,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Review began 11/07/2025  \nReview ended 11/26/2025  \nPublished 12/01/2025  \n© Copyright 2025  \nBhardwaj et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98275  \nOpen Access Review Article  \nAntipsychotic Misuse: A Silent but Growing Public Health Hazard  \nSumeet Bhardwaj 1, Karisma Pathak 1 , Myra McLenon 2, Steven Spector 2, Kevin Tu 3  \n1. Psychiatry, Kansas City University, Kansas City, USA 2. General Medicine, Kansas City University, Kansas City, USA  \n3. General Medicine, Kansas City University of Medicine and Biosciences, Kansas City, USA Corresponding author: Sumeet Bhardwaj, [theranger122@gmail.com](theranger122@gmail.com)  \nAbstract  \nAntipsychotic drugs are essential in the management of schizophrenia, bipolar disorder, and other psychiatric illnesses, but their use is closely linked to cardiometabolic side effects. Cardiometabolic side effects include weight gain, dyslipidemia, glucose intolerance, and increased cardiovascular morbidity and mortality. Mechanisms of cardiometabolic side effects involve disruption of the central nervous system’s ability to regulate appetite, peripheral metabolic effects, which are changes in metabolism outside the CNS, and receptor-level interactions, with second-generation antipsychotics generally posing a greater risk than first-generation agents. This review addresses current evidence on the cardiometabolic consequences of antipsychotic therapy, increasing inappropriate off-label use of antipsychotic drugs, particularly those that are atypical, highlights vulnerable populations, and discusses strategies for monitoring and mitigation. A secondary goal is to address the considerable literature gap covering recent trends and costs in the off-label use of atypical antipsychotic drugs.  \nCategories: Psychiatry, Cardiology, Endocrinology/Diabetes/Metabolism  \nKeywords: antipsychotic drugs, cardiometabolic risk, cardiovascular disease, health disparities, insulin resistance, metabolic monitoring, metabolic syndrome, off-label prescribing, pharmacovigilance, second-generation antipsychotics  \nIntroduction And Background  \nAntipsychotic drugs have transformed psychiatric care by enabling effective management of psychotic symptoms and allowing millions of individuals with severe mental illness to live outside institutional settings and to be spared treatments that would be considered to be outdated today [1] . Beyond schizophrenia, antipsychotics are also prescribed for bipolar disorder, treatment-resistant depression, and a variety of pediatric and developmental disorders [2] . This review does not aim to portray antipsychotics as inherently harmful, but rather to highlight that their expanding use demands careful risk-benefit assessment, particularly regarding atypical antipsychotics and their potential cardiometabolic effects.  \nAlthough antipsychotics have transformed psychiatric care, their use has also extended far beyond approved indications. In this review, off-label refers to the prescription of antipsychotic medications for conditions outside their original regulatory approval. While a handful of off-label uses, such as for treatment of major depressive disorder, augmentation in treatment-resistant obsessive-compulsive disorder, or management of severe agitation, have modest empirical support, most other applications lack any convincing evidence.  \nDespite their widespread use for insomnia, anxiety, personality disorders, dementia-related behaviors, and post-traumatic stress disorder, controlled trials generally show minimal or no benefit [3] . In practice, the vast majority of off-label antipsychotic prescribing reflects clinical habits despite a lack of sufficient evidence to alleviate issues such as insomnia and anxiety due to their strong antihistaminer","cbCaim7l6Tx72ilK","https://ap.wps.com/l/cbCaim7l6Tx72ilK","pdf",3074173,17,"English","# Abstract\n# Introduction And Background\n## Off-label use beyond approved indications\n## Evidence on trends and utilization\n## Mechanisms and implications for risk","[{\"question\":\"What cardiometabolic side effects are linked to antipsychotic use?\",\"answer\":\"Antipsychotic use is associated with weight gain, dyslipidemia, glucose intolerance, and higher cardiovascular morbidity and mortality.\"},{\"question\":\"How does off-label prescribing of antipsychotics relate to evidence quality?\",\"answer\":\"A small number of off-label uses have modest empirical support, while many other applications lack convincing evidence, despite widespread prescribing for conditions like insomnia and anxiety.\"},{\"question\":\"What trends in off-label atypical antipsychotic use are highlighted?\",\"answer\":\"Visits involving off-label use with uncertain evidence increased substantially for atypical agents from 1995 to 2008, with a nearly tenfold escalation in utilization.\"}]","Antipsychotic Misuse: A Silent but Growing Public Health Hazard | PDF",1790588221,43]