A major new Lancet Psychiatry Commission led by Halstead, Yap, McCutcheon, Siskind, Pillinger, and an international consortium (2025) argues that mental health treatment must move beyond symptom reduction alone and place equal importance on protecting physical health. While psychotropic medications—including antidepressants, antipsychotics, and mood stabilisers—remain essential for many people, the authors emphasise that these medications can also produce substantial physical side effects across multiple body systems, including metabolic, cardiac, neurological, endocrine, gastrointestinal, renal, and sexual health domains.

Rather than viewing side effects as isolated issues, the Commission proposes a systems-based, whole-person framework that integrates prevention, monitoring, and early intervention. Shared decision-making is central: people should receive clear, accessible information about both benefits and risks before starting treatment, with ongoing collaborative review. The report particularly highlights cardiometabolic complications such as weight gain, diabetes risk, and dyslipidaemia—especially with medications like olanzapine and clozapine—and recommends proactive strategies such as lifestyle intervention, careful medication selection, and early use of adjunctive treatments like metformin where appropriate.

Importantly, Halstead et al. (2025) stress that prescribing should not simply focus on psychiatric symptom management, but on preserving long-term quality of life and reducing preventable morbidity. Their Commission reinforces the ethical principle of first, do no harm, calling for psychiatry and primary care to adopt more integrated, person-centred, and multidisciplinary models. This work represents a substantial shift toward holistic medicines optimisation in mental health care—one that aligns strongly with broader Quality Use of Medicines and deprescribing movements.