Changes of Body Weight and Metabolic Syndrome in Psychiatric Inpatients

Jang, Woo Young; Lee, Kwang Hun; Bae, Na Ri; Lee, Sung Min; Kim, Tae Woo; Sakong, Jung Kyu; Kwak, Kyung Phil

Abstract

OBJECTIVE
This study explored the development of metabolic syndrome, changes in body weight and metabolic syndrome parameters (waist circumference, serum glucose and lipids, blood pressure), and effects of psychotropic agents in psychiatric inpatients being treated with psychotropic agents.
METHODS
In all, 146 patients who had been admitted to a psychiatric isolated ward for more than 1 month between August 2012 and May 2014 were included in this study. During hospitalization, levels of triglyceride, high density lipoprotein-cholesterol (HDL), low density lipoprotein-cholesterol, and serum glucose, and blood pressure, height, body weight, and waist circumference were regularly measured. For obtaining data on laboratory tests, physical examination and demographic and clinical characteristics, we reviewed patients' medical records.
RESULTS
After using psychotropic agents for 3 months, body mass index increased significantly and HDL levels decreased significantly. Of 119 patients without metabolic syndrome at baseline, 15 (12.61%) patients developed a this syndrome after 3 months. Among psychotropic agents, quetiapine most largely increased the number of patients who meet the criteria for metabolic syndrome (17.9%), and this change was significantly larger than that of aripiprazole (p=0.031). Carbamazepine significantly increased waist circumference. Duloxetine and lamotrigine significantly increased triglyceride levels. Olanzapine, aripiprazole, mirtazapine, duloxetine and valproic acid significantly decreased HDL levels. Futher, olanzapine and valproic acid significantly increased body mass index. Fluoxetine significantly decreased body mass index.
CONCLUSION
The results of this study indicate that at least 1 in 10 patients using psychotropic agents develop metabolic syndrome within a relatively short time; this finding emphasizes the importance of early diagnosis and treatment. Because abnormality of lipid parameters was prominent in early phase of treatment, clinicians should monitor these levels carefully. In addition, some psychotropic agents could affect body weight and metabolic syndrome parameters and thus clinicians should be aware of this changes in patients using psychotropic agents. Main limitation of this study is high drop-out rate (74%), and this could make the result underestimate.