Psychiatry Investig.  2015 Apr;12(2):242-248. 10.4306/pi.2015.12.2.242.

Metabolic Disturbances Independent of Body Mass in Patients with Schizophrenia Taking Atypical Antipsychotics

• Kang SH
• Lee JI

• KMID: 2316435
• DOI: http://doi.org/10.4306/pi.2015.12.2.242

Abstract

OBJECTIVE
Atypical antipsychotic (AAP) treatment is associated with weight gain and metabolic disturbances such as dyslipidemia and dysglycemia. The metabolic disturbances are usually considered to develop secondary to weight gain. We performed the comparison of metabolic disturbances of three AAP group with different risk of metabolic side effect after adjusting for body mass to investigate whether any metabolic disturbances develop independently from body mass index (BMI).
METHODS
This cross-sectional study included 174 subjects with schizophrenia who were on 1) monotherapy with clozapine (CL), olanzapine (OL), or quetiapine (QT) (n=61), 2) monotherapy with risperidone (RSP) (n=89), or 3) monotherapy with aripiprizole (ARP), or ziprasidone (ZPS) (n=24) more than 1 year. Association between the prevalence of metabolic disturbances and groups were analysed using logistic regression after adjusting confounding variables including BMI. Analysese of covariance were used to compare the AAP groups in terms of the levels of metabolic parameters.
RESULTS
There were significant differences among groups in terms of the prevalence of hypertriglyceridemia (p=0.015), low HDL-cholesterol (p=0.017), and hyperglycemia (p=0.022) after adjusting for BMI. Triglyceride level (p=0.014) and the ratio of triglyceride to HDL-cholesterol (p=0.004) were significantly different among groups after adjusting for BMI.
CONCLUSION
In conclusion, metabolic disturbances are significantly different in AAP groups even after adjusting BMI. AAPs may have direct effect on metabolic parameters. Blood lipid and glucose levels should be monitored regularly regardless of whether patients tend to gain weight.

Keyword

Schizophrenia; Dyslipidemia; Hyperglycemia; Atypical; Antipsychotics; Metabolic

MeSH Terms

Antipsychotic Agents*
Body Mass Index
Clozapine
Confounding Factors (Epidemiology)
Cross-Sectional Studies
Dyslipidemias
Glucose
Humans
Hyperglycemia
Hypertriglyceridemia
Logistic Models
Prevalence
Risperidone
Schizophrenia*
Triglycerides
Weight Gain
Quetiapine Fumarate
Antipsychotic Agents
Clozapine
Glucose
Risperidone