Intermittent Fasting as a Novel Treatment Approach for Patients Treated with Atypical Antipsychotics

Abstract

Meta-analyses often find similarities in tolerance between first and second generation antipsychotics. In terms of major barriers to treatment adherence, the extrapyramidal symptoms associated with the first generation antipsychotics have be replaced by the devastating association of weight gain and metabolic syndrome. Dietary and exercise prescriptions are currently being recommended for patients beginning treatment with atypical antipsychotics, although the details of this intervention are often left unclear. Intermittent fasting through time-restricted feeding windows is a practical lifestyle modification that has been shown to increase insulin sensitivity, prevent obesity and decrease risk of type II diabetes, thus making it a useful tool in the prevention of common metabolic issues surrounding atypical antipsychotics. In this review, we have combined the findings from the CATIE and CUtLASS trials with recent research on intermittent fasting and submit that the effectiveness of atypical antipsychotics may be enhanced via reductions in metabolic abnormalities associated with their usage. Our aim is to highlight intermittent fasting as a supplemental protocol to combat the metabolic consequences most prevalent with antipsychotics and to outline a prescription of how to utilize intermittent fasting in this patient population.