Metabolic syndrome in female patients with schizophrenia treated with second generation antipsychotics: a 3-month follow-up

• Published in: Journal of psychopharmacology (Oxford) 2009-11, Vol.23 (8), p.915-922
• Main Authors: Medved, V., Kuzman, MR, Jovanovic, N., Grubisin, J., Kuzman, T.
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Antipsychotic Agents - adverse effects; Antipsychotics; Biological and medical sciences; Blood Glucose - analysis; Blood pressure; Body mass; Body Mass Index; Cholesterol; Cholesterol, LDL - blood; Criteria; Diabetes; Diabetes mellitus; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Fasting; Female; Follow-Up Studies; Genetics; Glucose; Health risk assessment; Hip; Humans; Laboratory testing; Lipoproteins; Low density lipoprotein; Medical sciences; Mental disorders; Metabolic diseases; Metabolic syndrome; Metabolic Syndrome - chemically induced; Middle Aged; Miscellaneous; Neuropharmacology; Obesity; Olanzapine; Other metabolic disorders; Pharmacology. Drug treatments; Psycholeptics: tranquillizer, neuroleptic; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychopharmacology; Psychoses; Psychotropic drugs; Risperidone; Schizophrenia; Schizophrenia - blood; Schizophrenia - drug therapy; Triglycerides
• ISSN: 0269-8811; 1461-7285
• DOI: 10.1177/0269881108093927

The objective of this study was to determine the occurrence of metabolic abnormalities among previously unmedicated female patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition schizophrenia spectrum disorders and their associations with olanzapine and risperidone treatment. We analysed 94 female patients who were treated with olanzapine or risperidone in the period of 3 months. Analysed variables included fasting glucose, total cholesterol, low-density lipoprotein (LDL), high-density lipoproteins and triglycerides in blood, blood pressure (BP), waist and hip circumferences and body mass index (BMI). At baseline, 14 patients (15%) fulfilled criteria for metabolic syndrome. After 3 months of treatment, 25 patients (27%) fulfilled criteria for metabolic syndrome, and their baseline BMI was the only predictor for its development. Treatment with both antipsychotics was associated with significant increase in waist circumference. Positive family history of diabetes mellitus contributed to a significant greater increase in abdominal obesity, significant higher baseline levels and a borderline significant increase in fasting glucose among olanzapine-treated patients. Olanzapine admission was associated with a significant increase in LDL and risperidone with a significant increase in triglycerides. Metabolic abnormalities seem to be more prevalent in unmedicated female patients with schizophrenia spectrum disorders than expected based on results in general population (adjusted for age and sex). Olanzapine treatment might induce significant alterations in metabolic profiles, especially among patients with positive family history of diabetes, mostly by inducing abdominal obesity. The association of risperidone application and increase in triglyceride level still needs to be determined.