Korean J Schizophr Res.  2017 Apr;20(1):5-14. 10.16946/kjsr.2017.20.1.5.

The Effects on Metabolic Syndrome Parameters of Atypical Antipsychotic Agents in Schizophrenics Patients : 3 Years Retrospective Follow Up

Affiliations
  • 1Department of Psychiatry, National Center for Mental Health, Seoul, Korea. lji7542@naver.com
  • 2Department of Clinical Psychology, National Center for Mental Health, Seoul, Korea.
  • 3Department of Clinical Trial Center, Samsung Medical Center, Seoul, Korea.

Abstract


OBJECTIVES
Pharmacological treatment is critical on relapse prevention in patients with schizophrenia. However, atypical antipsychotic agents are known to cause weight gain more than typical agents despite their various effects. In addition, they are known to affect blood sugar, blood pressure, cholesterol, cardiac function, and sexual function. This study was designed to examine the effects on metabolic parameters when schizophrenic patients have been taken atypical antipsychotic agents.
METHODS
This was a trial in 137 patients with DSM-IV-TR schizophrenia who were admitted or treated in mental hospital. Anthropometric measurement and blood testing were conducted at baseline, 12 month, 36 month, and sociodemographic and treatment history were collected from medical records. We conducted height, weight, waist circumference, blood pressure, FBS, total cholesterol, HDL, triglyceride, and QTc interval. Metabolic syndrome was diagnosed by ATPIIIa criteria.
RESULTS
Aripiprazole showed the significant difference in the impact on weight, blood pressure, waist circumference, total cholesterol, HDL, triglyceride than paliperidone and olanzapine at 1-year and 3-year period. Olanzapine showed the significant increase of weight and triglyceride than paliperidone at 3-year period. The prevalence of metabolic syndrome increased in paliperidone at 1-year and in olanzapine at 3-year period compared to aripiprazole significantly.
CONCLUSION
We concluded that aripiprazole has less impact on the abdominal obesity, FBS, blood pressure, and cholesterol than paliperidone and olanzapine. Olanzapine showed the increase of long-term metabolic risk than other agents. There was needed the routine screening and multidisciplinary management of medical problems in schizophrenic patients for the prevention of metabolic syndrome.

Keyword

Schizophrenia; Atypical antipsychotics; Metabolic syndrome

MeSH Terms

Antipsychotic Agents*
Aripiprazole
Blood Glucose
Blood Pressure
Cholesterol
Cholesterol, HDL
Follow-Up Studies*
Hematologic Tests
Hospitals, Psychiatric
Humans
Mass Screening
Medical Records
Obesity, Abdominal
Paliperidone Palmitate
Prevalence
Retrospective Studies*
Schizophrenia
Secondary Prevention
Triglycerides
Waist Circumference
Weight Gain
Antipsychotic Agents
Aripiprazole
Blood Glucose
Cholesterol
Cholesterol, HDL
Paliperidone Palmitate

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