Atypical antipsychotics (AAPs) are commonly prescribed drugs in the treatment of schizophrenia, bipolar disorder and other mental diseases with psychotic traits. Although the use of AAPs is associated with beneficial effects in these patients, they are also associated with undesired metabolic side effects, including metabolic syndrome (MetS). MeS is defined by the presence of metabolic abnormalities such as large waist circumference, dyslipidemia, fasting hyperglycemia and elevated blood pressure, which predispose to type 2 diabetes (T2D) and cardiovascular disease. In this review, the molecular and cellular mechanisms involved in these undesired metabolic abnormalities induced by AAPs are described. These mechanisms are complex as AAPs have multiple cellular targets which significantly affect the activities of several hormones and neuromodulators. Additionally, AAPs affect all the relevant metabolic organs, namely the liver, pancreas, adipose tissue, skeletal muscle and intestine, and the central and peripheral nervous system as well. A better understanding of the molecular targets linking AAPs with MetS and of the mechanisms responsible for clinically different side effects of distinct AAPs is needed. This knowledge will help in the development of novel AAPs with less adverse effects as well as of adjuvant therapies to patients receiving AAPs.

中文翻译：

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非典型抗精神病药物的代谢作用：分子靶标

非典型抗精神病药（AAP）是治疗精神分裂症、双相情感障碍和其他具有精神病特征的精神疾病的常用处方药。尽管 AAP 的使用与这些患者的有益效果相关，但它们也与不良代谢副作用相关，包括代谢综合征 (MetS)。MeS 的定义是存在代谢异常，例如腰围过大、血脂异常、空腹高血糖和血压升高，这些异常容易导致 2 型糖尿病 (T2D) 和心血管疾病。在这篇综述中，描述了 AAP 诱导的这些不良代谢异常所涉及的分子和细胞机制。这些机制很复杂，因为 AAP 具有多个细胞靶标，可显着影响多种激素和神经调节剂的活性。此外，AAP 还影响所有相关的代谢器官，即肝脏、胰腺、脂肪组织、骨骼肌和肠道，以及中枢和周围神经系统。需要更好地了解连接 AAP 与 MetS 的分子靶点以及不同 AAP 临床上不同副作用的机制。这些知识将有助于开发副作用较小的新型 AAP 以及接受 AAP 的患者的辅助治疗。