The Canadian Network for Mood and Anxiety Treatments (Canmat) Task Force Recommendations for the Management of Patients with Mood Disorders and Comorbid Metabolic Disorders

McIntyre, Roger S.; Alsuwaidan, Mohammad; Goldstein, Benjamin I.; Taylor, Valerie H.; Schaffer, Ayal; Beaulieu, Serge; Kemp, David E.

doi:10.1177/104012371202400108

Cited by 46Bipolar Disorder and TreatmentEating Disorders and BehaviorsTreatment of Major Depression

The Canadian Network for Mood and Anxiety Treatments (Canmat) Task Force Recommendations for the Management of Patients with Mood Disorders and Comorbid Metabolic Disorders

McIntyre, Roger S., Alsuwaidan, Mohammad, Goldstein, Benjamin I., Taylor, Valerie H., Schaffer, Ayal, Beaulieu, Serge, Kemp, David E.·2012·Annals of Clinical Psychiatry

DOI 10.1177/104012371202400108

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Abstract

Background: One goal of the Canadian Network for Mood and Anxiety Treatments (CANMAT) is to develop evidence-based and best practice educational programs and recommendations. Our group conducted a comprehensive literature review to provide evidence-based recommendations for treating metabolic comorbidity in individuals with major depressive disorder (MDD) and bipolar disorder (BD). Methods: We searched PubMed for all English-language articles published January 1966 to November 2010 using BD and MDD cross-referenced with metabolic syndrome , obesity , diabetes mellitus , hypertension , and dyslipidemia . That search was augmented by a review of articles reporting outcomes of an intervention targeting components of metabolic syndrome in individuals with MDD or BD. Results: Consensus exists for the recommendation that individuals with MDD and BD should be routinely screened for risk factors that increase risk for metabolic syndrome. For excess weight, the best-studied pharmacologic approaches are metformin and topiramate, with emerging evidence for liraglutide and modafinil. For binge eating disorder, the best evidence in mood disorders was for cognitive-behavioral therapy as well as topiramate, zonisamide, and in select cases selective serotonin reuptake inhibitors. For dysglycemia, dyslipidemia, and hypertension, evidence supports cognitive-behavioral interventions and anti-diabetic, antilipidemic, and antihypertensive treatments. Conclusions: Comprehensive care of individuals with mood disorders should include routine evaluation of the risk and presence of metabolic syndrome and its components. Systematic evaluation of preventative and targeted treatments of metabolic syndrome in mood disorder populations is insufficient.

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“insufficient access to primary and preventative health care, low socioeconomic status, habitual inactivity, insulin dysfunction, peripheral inflammation and neuroinflammation, oxidative stress, and childhood adversity are also important contributors.785”
From Canadian Network for Mood and Anxiety Treatments ( <scp>CANMAT</scp> ) and International Society for Bipolar Disorders ( <scp>ISBD</scp> ) 2018 guidelines for the management of patients with bipolar disorder (2018) · cites this paper as [785]
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From Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder (2016) · cites this paper as [20]

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Friedman, J. I., Wallenstein, S. R., Moshier, E. L., Parrella, M. J., WHITE, L. E., Bowler, S., Gottlieb, S., Harvey, P. D., McGinn, T. G., Flanagan, L., et al. (2010) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2010.09091328 · Cited by 88 · see citing works
High‐dose escitalopram in the treatment of binge‐eating disorder with obesity: a placebo‐controlled monotherapy trial
Guerdjikova, A. I., McElroy, S. L., Kotwal, R., Welge, J. A., Nelson, E. B., Lake, K., Alessio, D. D., Keck, P. E., & Hudson, J. I. (2007) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.899 · Cited by 86 · see citing works
Orlistat: current status in clinical therapeutics
McClendon, K. S., Riche, D. M., & Uwaifo, G. I. (2009) · Expert Opinion on Drug Safety · doi:10.1517/14740330903321485 · Cited by 84 · see citing works
Lamotrigine in the treatment of binge-eating disorder with obesity: a randomized, placebo-controlled monotherapy trial
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Brain volume abnormalities and neurocognitive deficits in diabetes mellitus: Points of pathophysiological commonality with mood disorders?
McIntyre, R. S., Kenna, H. A., Nguyen, H. T., Law, C. W. Y., Sultan, F., Woldeyohannes, H. O., Alsuwaidan, M. T., Soczynska, J. K., Adams, A. K., Cheng, J. S. H., et al. (2010) · Advances in Therapy · doi:10.1007/s12325-010-0011-z · Cited by 83 · see citing works
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Metabolic Syndrome Over 10 Years and Cognitive Functioning in Late Midlife
Akbaraly, T. N., Mika Kivimaki, B., Shipley, M. J., Tabák, Á. G., Jokela, M. M., Virtanen, M., Marmot, M. G., Ferrie, J. E., & Singh‐Manoux, A. (2009) · Diabetes Care · doi:10.2337/dc09-1218 · Cited by 80 · see citing works
Psychiatric Diagnosis and Weight Loss following Gastric Surgery for Obesity
Black, D. W., Goldstein, R. B., & Mason, E. E. (2003) · Obesity Surgery · doi:10.1381/096089203322509327 · Cited by 74 · see citing works
Efficacy and safety of topiramate in combination with metformin in the treatment of obese subjects with type 2 diabetes: a randomized, double-blind, placebo-controlled study
for the OBDM-002 Study Group, Toplak, H., Hamann, A., Moore, R., Masson, E., Górska, M., Vercruysse, F., Sun, X., & Fitchet, M. (2006) · International Journal of Obesity · doi:10.1038/sj.ijo.0803382 · Cited by 74 · see citing works
The Metabolic Syndrome, Depression, and Cardiovascular Disease: Interrelated Conditions that Share Pathophysiologic Mechanisms
Gans, R. O. B. (2006) · Medical Clinics of North America · doi:10.1016/j.mcna.2006.05.002 · Cited by 64 · see citing works
Bupropion for weight reduction
Gadde, K. M., & Xiong, G. L. (2006) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.7.1.17 · Cited by 64 · see citing works
Changes in weight and metabolic parameters during treatment with antipsychotics and metformin: do the data inform as to potential guideline development? A systematic review of clinical studies
Bushe, C., Bradley, A. J., Doshi, S. M., & Karagianis, J. L. (2009) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2009.02224.x · Cited by 56 · see citing works
The Effect of Metformin on Anthropometrics and Insulin Resistance in Patients Receiving Atypical Antipsychotic Agents
Ehret, M. J., Goethe, J. W., Lanosa, M., & Coleman, C. I. (2010) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.09m05274yel · Cited by 55 · see citing works
Wake-promoting agents with different mechanisms of action: comparison of effects of modafinil and amphetamine on food intake and cardiovascular activity.
Makris, A., Rush, C., Frederich, R., & Kelly, T. (2004) · Appetite · doi:10.1016/j.appet.2003.11.003 · Cited by 54 · see citing works
Exercise and Bipolar Disorder: A Review of Neurobiological Mediators
Alsuwaidan, M. T., Kucyi, A., Law, C. W. Y., & McIntyre, R. S. (2009) · NeuroMolecular Medicine · doi:10.1007/s12017-009-8079-9 · Cited by 53 · see citing works
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Increased Cholesterol Levels During Paroxetine Administration in Healthy Men
Lara, N., Baker, G. B., Archer, S. L., & Mellédo, J. L. (2003) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v64n1209 · Cited by 46 · see citing works
Change in Mental Symptoms in Extreme Obesity Patients after Gastric Banding, Part II: Six-Year Follow up
Nickel, M. K., Loew, T. H., & Bachler, E. (2007) · The International Journal of Psychiatry in Medicine · doi:10.2190/x40r-712p-8j44-0l3h · Cited by 46 · see citing works
The rate of metabolic syndrome in euthymic Canadian individuals with bipolar I/II disorder
McIntyre, R. S., Woldeyohannes, H. O., Soczynska, J. K., Miranda, A., Lachowski, A. M., Liauw, S. S. L., Grossman, T., Lourenço, M. T. C., Kim, B., Alsuwaidan, M. T., et al. (2010) · Advances in Therapy · doi:10.1007/s12325-010-0072-z · Cited by 37 · see citing works
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Metabolic Syndrome in Patients Enrolled in a Clinical Trial of Aripiprazole in the Maintenance Treatment of Bipolar I Disorder
Kemp, D. E., Calabrese, J. R., Tran, Q.-V., Pikalov, A., Eudicone, J. M., & Baker, R. A. (2010) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.09m05159gre · Cited by 34 · see citing works
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Sodium oxybate in the treatment of binge eating disorder: An open‐label, prospective study
McElroy, S. L., Guerdjikova, A. I., Winstanley, E. L., O’Melia, A. M., Mori, N. N., Keck, P. E., & Hudson, J. I. (2010) · International Journal of Eating Disorders · doi:10.1002/eat.20798 · Cited by 34 · see citing works
Depression and the Heart: A Systematic Overview of Definition, Measurement, Consequences and Treatment of Depression in Cardiovascular Disease
Dobbels, F., Geest, S. D., Vanhees, L., Schepens, K., Fagard, R., & Vanhaecke, J. (2002) · European Journal of Cardiovascular Nursing · doi:10.1016/s1474-5151(01)00012-3 · Cited by 33 · see citing works
Beneficial Effects of Pharmacotherapy on Weight Loss, Depressive Symptoms, and Eating Patterns in Obese Binge Eaters and Non‐Binge Eaters
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Best Practice Updates for Surgical Care in Weight Loss Surgery
Kelly, J. J., Shikora, S. A., Jones, D. B., Hutter, M., Robinson, M. K., Romanelli, J. R., Buckley, F., Lederman, A. B., Blackburn, G. L., & Lautz, D. B. (2009) · Obesity · doi:10.1038/oby.2008.570 · Cited by 26 · see citing works
Adjunctive zonisamide for weight loss in euthymic bipolar disorder patients: A pilot study
Wang, P. W., Yang, Y.-S., Chandler, R. A., Nowakowska, C., Alarcon, A. M., Culver, J. L., & Ketter, T. A. (2007) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2007.05.005 · Cited by 26 · see citing works
Impact of Antidepressant Use on Gastric Bypass Surgery Patients’ Weight Loss and Health-Related Quality-of-Life Outcomes
Love, R. J., Love, A. S., Bower, S., & Poston, W. S. C. (2008) · Psychosomatics · doi:10.1176/appi.psy.49.6.478 · Cited by 26 · see citing works
Cholesterol and affective morbidity
Fiedorowicz, J. G., Palagummi, N. M., Behrendtsen, O., & Coryell, W. H. (2009) · Psychiatry Research · doi:10.1016/j.psychres.2009.01.001 · Cited by 26 · see citing works
Lithium augmentation of topiramate for bipolar disorder with comorbid binge eating disorder and obesity
Kotwal, R., Guerdjikova, A. I., McElroy, S. L., & Keck, P. E. (2006) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.783 · Cited by 24 · see citing works
Phentermine cardiovascular safety
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Psychotic mania associated with fenfluramine and phentermine use
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Nonalcoholic Steatohepatitis: A Review of the Literature and Updates in Management
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Ziprasidone with adjunctive mood stabilizer in the maintenance treatment of bipolar I disorder: Long-term changes in weight and metabolic profiles
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Insulin Resistance Syndrome and Neuropsychiatric Disease
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Bariatric surgery in patients with bipolar disorder: an emerging issue
Taylor, V. H., & Misra, M. (2009) · Journal of Psychiatry and Neuroscience · doi:10.1139/jpn.0943 · Cited by 4 · see citing works
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Canadian Network for Mood and Anxiety Treatments ( <scp>CANMAT</scp> ) and International Society for Bipolar Disorders ( <scp>ISBD</scp> ) 2018 guidelines for the management of patients with bipolar disorder
Yatham, L. N., Kennedy, S. H., Parikh, S. V., Schaffer, A., Bond, D. J., Frey, B. N., Sharma, V., Goldstein, B. I., Rej, S., Beaulieu, S., et al. (2018) · Bipolar Disorders · doi:10.1111/bdi.12609 · Cited by 1,852 · see citing works
Self-citation
Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta‐analysis
Vancampfort, D., Stubbs, B., Mitchell, A. J., De Hert, M., Wampers, M., Ward, P. B., Rosenbaum, S., & Correll, C. U. (2015) · World Psychiatry · doi:10.1002/wps.20252 · Cited by 1,271 · see citing works
“Thus, screening for and trying to minimize risk factors (including adverse lifestyle factors and antipsychotic medication choice and use) should be a key priority in the multidisciplinary treatment of people with SMI (46-49).”
Background
Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders
Katzman, M. A., Bleau, P., Blier, P., Chokka, P., Kjernisted, K., Van Ameringen, M., & the Canadian Anxiety Guidelines Initiative Group on behalf of the Anxiety Disorders Association of Canada/Association Canadienne des troubles anxieux and McGill University (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-s1-s1 · Cited by 1,090 · see citing works
“While glycemic measures do not appear to be affected by anxiety symptoms [1447], some treatments, particularly some atypical antipsychotics, alter glucose parameters, lipid levels, and cause weight gain [109-116,1443].”
Background
Diabetes mellitus in people with schizophrenia, bipolar disorder and major depressive disorder: a systematic review and large scale meta‐analysis
Vancampfort, D., Correll, C. U., Galling, B., Probst, M., De Hert, M., Ward, P. B., Rosenbaum, S., Gaughran, F., Lally, J., & Stubbs, B. (2016) · World Psychiatry · doi:10.1002/wps.20309 · Cited by 659 · see citing works
“Thus, considering the observed increased T2DM risks, screening for and trying to minimize risk factors (including adverse lifestyle factors and specific antipsychotic medication choice) should be a key priority in the multidisciplinary treatment of people with SMI (36-39).”
Background
Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder
Parikh, S. V., Quilty, L. C., Ravitz, P., Rosenbluth, M., Pavlova, B., Grigoriadis, S., Velyvis, V., Kennedy, S. H., Lam, R. W., MacQueen, G. M., et al. (2016) · The Canadian Journal of Psychiatry · doi:10.1177/0706743716659418 · Cited by 562 · see citing works
“The CANMAT task force also addressed the management of mood disorders and comorbid medical conditions.(20,25,26) There is insufficient evidence to define formal treatment recommendations, so instead only evidence is summarized.”
Background
Major Depressive Disorder and Bipolar Disorder Predispose Youth to Accelerated Atherosclerosis and Early Cardiovascular Disease: A Scientific Statement From the American Heart Association
Goldstein, B. I., Carnethon, M. R., Matthews, K. A., McIntyre, R. S., Miller, G. E., Raghuveer, G., Stoney, C. M., Wasiak, H., & McCrindle, B. W. (2015) · Circulation · doi:10.1161/cir.0000000000000229 · Cited by 519 · see citing works
“† There has been cross-sectional and longitudinal evidence of a bidirectional association between BD and overweight/ obesity.(64) In a large cohort of children and adolescents with BD, 42% of participants were overweight/obese.”
BackgroundSelf-citation
Lifestyle medicine for depression
Sarris, J., O’Neil, A., Coulson, C. E., Schweitzer, I., & Berk, M. (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-107 · Cited by 450 · see citing works
“Regardless of the current deficit of empirical evidence for prescriptive dietary advice to treat depression, it is recognized that diet has a major impact on comorbid medical conditions that are exceedingly more common in people diagnosed with depression, including cardiovascular disease and metabolic disorders [48],…”
Background
The International College of Neuro-Psychopharmacology (CINP) treatment guidelines for Bipolar disorder in adults (CINP-BD-2017), part 3: The clinical guidelines.
Fountoulakis, K. Ν., Grunze, H., Vieta, E., Young, A. H., Yatham, L. N., Blier, P., Kasper, S. F., & Moeller, H. J. (2016) · The International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyw109 · Cited by 248 · see citing works
Mental health collaborative care and its role in primary care settings
Goodrich, D. E., Kilbourne, A. M., Nord, K. M., & Bauer, M. S. (2013) · Current Psychiatry Reports · doi:10.1007/s11920-013-0383-2 · Cited by 216 · see citing works
Diabetes mellitus and severe mental illness: mechanisms and clinical implications
Holt, R. I. G., & Mitchell, A. J. (2014) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2014.203 · Cited by 181 · see citing works
Obesity in Bipolar Disorder: An Overview
McElroy, S. L., & Keck, P. E. (2012) · Current Psychiatry Reports · doi:10.1007/s11920-012-0313-8 · Cited by 124 · see citing works
“The general approach to treating the BD patient with obesity is to choose pharmacologic agents that are efficacious for the patient’s BD symptoms and that are weight neutral or, if available, associated with weight loss [2, 5].”
Background
The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 2: Review, Grading of the Evidence, and a Precise Algorithm
Fountoulakis, K. Ν., Yatham, L. N., Grunze, H., Vieta, E., Young, A. H., Blier, P., Kasper, S. F., & Moeller, H. J. (2016) · The International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyw100 · Cited by 115 · see citing works
Efficacy and safety of adjunctive topiramate for schizophrenia: a meta‐analysis of randomized controlled trials
Zheng, W., Xiang, Y., Xiang, Y., Li, X. ‐., Ungvari, G. S., Chiu, H. F. K., & Correll, C. U. (2016) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12631 · Cited by 63 · see citing works
Metformin for the prevention of antipsychotic-induced weight gain: guideline development and consensus validation
Carolan, A., Hynes-Ryan, C., Agarwal, S. M., Bourke, R., Cullen, W., Gaughran, F., Hahn, M. K., Krivoy, A., Lally, J., Leucht, S., et al. (2025) · Schizophrenia Bulletin · doi:10.1093/schbul/sbae205 · Cited by 70 · see citing works
Weight changes associated with antiepileptic mood stabilizers in the treatment of bipolar disorder
Grootens, K. P., Meijer, A., Hartong, E. G., Doornbos, B., Bakker, P. R., Al Hadithy, A., Hoogerheide, K. N., Overmeire, F., Marijnissen, R. M., & Ruhe, H. G. (2018) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-018-2517-2 · Cited by 60 · see citing works
The effect of bariatric surgery on psychiatric course among patients with bipolar disorder
Ahmed, A. T., Warton, E. M., Schaefer, C. A., Shen, L., & McIntyre, R. S. (2013) · Bipolar Disorders · doi:10.1111/bdi.12109 · Cited by 49 · see citing works
“In addition to being at increased risk for obesity, patients with BD have an unmet need for obesity treatment (31) and may be denied surgical treatment due to their psychiatric diagnosis.”
BackgroundSelf-citation
Employment Outcomes One Year after Bariatric Surgery: the Role of Patient and Psychosocial Factors
Sockalingam, S., Wnuk, S., Kantarovich, K., Meaney, C. A., Okrainec, A., Hawa, R., & Cassin, S. E. (2014) · Obesity Surgery · doi:10.1007/s11695-014-1443-3 · Cited by 45 · see citing works
Improving medication-related outcomes for patients with psychiatric and neurologic disorders: Value of psychiatric pharmacists as part of the health care team
Goldstone, L. W., DiPaula, B. A., Caballero, J., Park, S. H., Price, C., & Slater, M. Z. (2015) · Mental Health Clinician · doi:10.9740/mhc.2015.01.001 · Cited by 40 · see citing works
Comorbid anxiety disorders alter the association between cardiovascular diseases and depression: the German National Health Interview and Examination Survey
Tully, P. J., & Baune, B. T. (2013) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-013-0784-x · Cited by 37 · see citing works
“The global disease and morbidity burden attributable to depression and CVDs [15] underscore the necessity to explore alternative epidemiological and biological models to inform our understandings and make appropriate treatment recommendations [16].”
Background
Obesity and Bipolar Disorder: Synergistic Neurotoxic Effects?
Liu, C. S., Carvalho, A. F., Mansur, R. B., & McIntyre, R. S. (2013) · Advances in Therapy · doi:10.1007/s12325-013-0067-7 · Cited by 36 · see citing works
Self-citation
Associations of symptoms of anxiety and depression with diabetes and cardiovascular risk factors in older people with intellectual disability
de Winter, C. F., Hermans, H., Evenhuis, H. M., & Echteld, M. A. (2013) · Journal of Intellectual Disability Research · doi:10.1111/jir.12049 · Cited by 36 · see citing works
Integrating Bipolar Disorder Management in Primary Care
Kilbourne, A. M., Goodrich, D. E., O’Donnell, A. N., & Miller, C. J. (2012) · Current Psychiatry Reports · doi:10.1007/s11920-012-0325-4 · Cited by 32 · see citing works
Rimonabant effects on anxiety induced by simulated public speaking in healthy humans: a preliminary report
Bergamaschi, M. M., Queiróz, R. H. C., Chagas, M. H. N., Linares, I. M. P., Arrais, K. C., de Oliveira, D. C. G., Queiroz, M. E. C., Nardi, A. E., Huestis, M. A., Hallak, J. E. C., et al. (2013) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.2374 · Cited by 31 · see citing works
Psychological and Psychiatric Aspects of Treatment of Obesity and Nonalcoholic Fatty Liver Disease
Stewart, K. E., & Levenson, J. L. (2012) · Clinics in Liver Disease · doi:10.1016/j.cld.2012.05.007 · Cited by 23 · see citing works
“In addition to weight gain associated with psychotropic medications, several common factors may contribute to the risk of both obesity and psychiatric disorders, including habitual inactivity, neuroinflammation, insufficient access to health care, alterations in neurometabolism, and oxidative stress.(39) Psychiatric i…”
Background
The Black Book of Psychotropic Dosing and Monitoring
DeBattista, C., & Schatzberg, A. F. (2025) · Psychopharmacology Bulletin · doi:10.64719/pb.4493 · Cited by 22 · see citing works
Physical health in affective disorders: a narrative review of the literature
Colomer, L., Anmella, G., Vieta, E., & Grande, I. (2020) · Brazilian Journal of Psychiatry · doi:10.1590/1516-4446-2020-1246 · Cited by 18 · see citing works
Metabolic syndrome in first‐time hospitalized patients with depression: a 1‐year follow‐up study
Nyboe, L., Vestergaard, C. H., Lund, H., Møller, M. K., & Videbech, P. (2015) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12470 · Cited by 16 · see citing works
“Yet, like other patients with severe mental illness, patients with depression have an increased risk for premature death (7, 8) and CVD is among the most common causes (9, 10).”
Background
Managing Medical and Psychiatric Comorbidity in Individuals with Major Depressive Disorder and Bipolar Disorder
McIntyre, R. S., Rosenbluth, M., Ramasubbu, R., Bond, D. J., Taylor, V. H., Beaulieu, S., & Schaffer, A. (2012) · Annals of Clinical Psychiatry · doi:10.1177/104012371202400209 · Cited by 70 · see citing works
Self-citation
Obesity and Mental Illness: Implications for Cognitive Functioning
McIntyre, R. S., Cha, D. S., Jerrell, J. M., Soczynska, J. K., Woldeyohannes, H. O., Taylor, V. H., Kaidanovich‐Beilin, O., Alsuwaidan, M. T., & Ahmed, A. T. (2013) · Advances in Therapy · doi:10.1007/s12325-013-0040-5 · Cited by 14 · see citing works
“The recommendations, albeit for individuals with mood disorders, can be applied to all individuals with NPD [92].”
BackgroundInfluentialSelf-citation
Metabolic syndrome and related variables, insulin resistance, leptin levels, and PPAR-γ2 and leptin gene polymorphisms in a pedigree of subjects with bipolar disorder
Baptista, T., Sandia, I., Fernández, É., Balzán, L., Connell, L., Uzcátegui, E., Serrano, A., Pabon, A., Angeles, F., Araque, Y., et al. (2015) · Brazilian Journal of Psychiatry · doi:10.1590/1516-4446-2014-1425 · Cited by 13 · see citing works
Improving Outcomes in Patients With Bipolar Depression
Nierenberg, A. A., McIntyre, R. S., & Sachs, G. S. (2015) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.13091ip1 · Cited by 12 · see citing works
Self-citation
A Post Hoc Analysis of the Effect of Weight on Efficacy in Depressed Patients Treated With Desvenlafaxine 50 mg/d and 100 mg/d
McIntyre, R. S., Fayyad, R. S., Guico‐Pabia, C. J., & Boucher, M. (2015) · The Primary Care Companion For CNS Disorders · doi:10.4088/pcc.14m01741 · Cited by 11 · see citing works
Self-citation
Deconstructing Diabetes and Depression: Clinical Context, Treatment Strategies, and New Directions
Gregory, J. M., Rosenblat, J. D., & McIntyre, R. S. (2016) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20150040 · Cited by 10 · see citing works
Self-citation
Cardiometabolic Health in Bipolar Disorder
Kemp, D. E., & Fan, J. (2012) · Psychiatric Annals · doi:10.3928/00485713-20120507-05 · Cited by 10 · see citing works
Self-citation
Implementation of psychiatric‐focused lifestyle medicine programs in A sia
Sarris, J. J., Nishi, D., Xiang, Y., Su, K., Bannatyne, A. J., Oliver, G., Kua, E. H., & Ng, C. H. (2015) · Asia-Pacific Psychiatry · doi:10.1111/appy.12212 · Cited by 9 · see citing works
“It is evident that adequate PA and exercise is of synergistic relevance, given the increased burden of obesity and the metabolic syndrome in individuals with psychiatric disorders (McIntyre et al., 2012).”
Background
Resistant bipolar depressive disorder: case analysis of adjunctive transcranial magnetic stimulation efficiency in medical comorbid conditions
Zendjidjian, X., Lodovighi, M.-A., Richieri, R., Guedj, E., Boyer, L., Dassa, D., & Lançon, C. (2014) · Bipolar Disorders · doi:10.1111/bdi.12170 · Cited by 7 · see citing works
“The evidentiary base that informs therapeutic decisions remains woefully inadequate and justifies the development of new recommendations with consideration of medical comorbidities (10, 11).”
Background
Psychological Biomarker Profile in NAFLD/NASH with Advanced Fibrosis
Funuyet‐Salas, J., Rodríguez, A. M., Conrad, R., & Pérez-San-Gregorio, M. Á. (2020) · Springer eBooks · doi:10.1007/978-3-030-37173-9_12 · Cited by 9 · see citing works
Peroxisome Proliferator-Activated Receptor Gamma (PPARγ) Levels in Adolescent with Bipolar Disorder and Their Relationship with Metabolic Parameters
Kaşak, M., Ceylan, M., Hesapçıoğlu, S. T., Şenat, A., & Erel, Ö. (2022) · Journal of Molecular Neuroscience · doi:10.1007/s12031-022-02000-2 · Cited by 7 · see citing works
Is bipolar disorder associated with premature aging?
Brietzke, E. M., Cerqueira, R. O., Soares, C. N., & Kapczinski, F. P. (2019) · Trends in Psychiatry and Psychotherapy · doi:10.1590/2237-6089-2019-0038 · Cited by 7 · see citing works
Medición de la concordancia en la elección de antidepresivos entre psiquiatras costarricenses que no aplican y sí aplican el Algoritmo de Razonamiento Psicofarmacológico
González, R. M., Brenes, M. C., Chavarría, A. R., & Quesada, J. A. A. (2020) · Acta Médica Costarricense · doi:10.51481/amc.v61i1.1021 · Cited by 1 · see citing works
Metabolic Syndrome in Bipolar Disorder: Review and Management
Regan, A. S., & Valcourt, S. C. (2020) · Psychiatric Annals · doi:10.3928/00485713-20200713-01 · Cited by 1 · see citing works
Integrated Case Summary
Hawa, R., & Sockalingam, S. (2016) · Springer eBooks · doi:10.1007/978-3-319-42536-8_24
Part I: Interactive case: Adverse effects associated with antipsychotic therapy
Gardner, K. N. (2021) · JACCP JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY · doi:10.1002/jac5.1563
Psychosocial consequences
Vieta, E. (2013) · doi:10.1007/978-1-908517-94-4_2
Effects of acupuncture combined with medication on patients with COVID-19 complicated with bipolar disorder: A protocol of systematic review and meta-analysis
Huang, W., Zhu, L., Wu, M., Teng, L., Zhang, M., & Song, W. (2022) · Medicine · doi:10.1097/md.0000000000031474
“[21] This, along with side effects (such as weight gain), high recurrence, and high cost, has led to high treatment discontinuation and conversion rates of patients with BD.[22] Based on the fact that during the outbreak of the COVID-19 pandemic, it has a greater impact on patients with BD and newly diagnosed patients…”
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MATSUURA, Y., & Hongo, S. (2023) · Medical Acupuncture · doi:10.1089/acu.2023.0051

Managing Medical and Psychiatric Comorbidity in Individuals with Major Depressive Disorder and Bipolar Disorder
McIntyre, R. S., Rosenbluth, M., Ramasubbu, R., Bond, D. J., Taylor, V. H., Beaulieu, S., & Schaffer, A. (2012) · Annals of Clinical Psychiatry · doi:10.1177/104012371202400209 · Cited by 70 · see citing works
Self-citation
Targeting Metabolic Dysfunction for the Treatment of Mood Disorders: Review of the Evidence
Jones, B. D. M., Farooqui, S., Kloiber, S. M., Husain, M. O., Mulsant, B. H., & Husain, M. I. (2021) · Life · doi:10.3390/life11080819 · Cited by 35 · see citing works
Metabolic Syndrome in Bipolar Disorder
McElroy, S. L., & Keck, P. E. (2014) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.13r08634 · Cited by 99 · see citing works
Metabolic Syndrome and Bipolar Disorder: What Should Psychiatrists Know?
de Almeida, K. M., Moreira, C. L. R. L., & Lafer, B. (2012) · CNS Neuroscience & Therapeutics · doi:10.1111/j.1755-5949.2011.00240.x · Cited by 64 · see citing works
Bipolar disorder and metabolic syndrome: comorbidity or side effects of treatment of bipolar disorder.
Babic, D. D., Maslov, B., Martinac, M., Nikolić, K., Uzun, S., & Kozumplik, O. (2010) · PubMed · Cited by 31 · see citing works

Authors: McIntyre, R. S., Alsuwaidan, M., Goldstein, B. I., Taylor, V. H., Schaffer, A., Beaulieu, S., & Kemp, D. E.
Affiliations: University Health Network (CA)
Sunnybrook Health Science Centre (CA)
University of Toronto (CA)
Douglas Mental Health University Institute (CA)
University Hospitals of Cleveland (US)
Corresponding author: McIntyre, Roger S.
ORCID: McIntyre, Roger S.
Alsuwaidan, Mohammad
Goldstein, Benjamin I.
Taylor, Valerie H.
Schaffer, Ayal
Beaulieu, Serge
Kemp, David E.
Venue: Annals of Clinical Psychiatry
Publisher: SAGE Publications
Published: 2012-02
Volume: 24
Issue: 1
Pages: 69-81
ISSN: 1040-1237 (ISSN-L)
1547-3325
DOI: 10.1177/104012371202400108
OpenAlex: W4414164781
Cited by: 45
References: 107
Citations by year: 2025: 1 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 4 · 2019: 1 · 2018: 2 · 2016: 7 · 2015: 8 · 2014: 4 · 2013: 9 · 2012: 5
FWCI: 5.94
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Annals of Clinical Psychiatry (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords: mood disorders, metabolic comorbidities, metabolic syndrome, major depressive disorder, bipolar disorder, obesity, diabetes mellitus, hypertension, dyslipidemia, binge eating disorder, metformin, topiramate, liraglutide, modafinil, cognitive behavioral therapy, screening, treatment guidelines
MeSH terms: Central Nervous System Stimulants, Bipolar Disorder, Canada, Depressive Disorder, Major, Major Depressive Disorder, Diabetes Mellitus, Humans, Hypertension, Metabolic Diseases, Obesity, Antipsychotic Agents, Comorbidity, Anti-Obesity Agents, Mood Disorders, Metabolic Syndrome, Advisory Committees, Bariatric Surgery, Dyslipidemias, Binge-Eating Disorder

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