Prevalence of obesity, glucose homeostasis disorders and metabolic syndrome in psychiatric patients taking typical or atypical antipsychotic drugs: a cross-sectional study.
OBJECTIVE
Atypical antipsychotic drugs may be associated with obesity and other components of the metabolic syndrome, but this relationship is controversial. We investigated the hypothesis that atypical antipsychotics are associated with a greater degree of metabolic dysfunction than typical agents.


METHODS
Metabolic parameters were measured in 103 diagnostically heterogeneous psychiatric out-patients. Patients had been taking typical or atypical antipsychotic drugs for a minimum of six months.


RESULTS
Sixty-nine patients were taking atypical agents, 20 typical agents and 14 a combination. Mean values (+/-SD) for the whole group were: age 43.8 years (11.4); BMI 29.1 kg/m(2) (5.1); W:H ratio 0.88 (0.09). Metabolic parameters, including beta cell function and insulin sensitivity, measured by HOMA, did not differ with regard to the prescribed antipsychotic drug. Six patients had undiagnosed diabetes, six patients had impaired fasting glucose, and eight fulfilled criteria for the metabolic syndrome, all of whom were taking atypical agents (p=0.07 vs typical agents). Subgroup analyses of those taking atypical agents revealed differences in BMI (mean, +/-SD) between olanzapine (27.3 kg/m(2)+/-5.1) and quetiapine (31.9 kg/m(2)+/-5.1), p=0.01, and HbA(1c) (olanzapine, 5.1%+/-0.6 vs quetiapine, 5.6%+/-0.6; p=0.03). Other atypical agents were intermediate with regard to these parameters.


CONCLUSIONS
Obesity, dyslipidaemia and abnormalities of glucose homeostasis are prevalent in this group. Patients taking atypical agents showed a trend towards abnormalities of glucose homeostasis. Prospective studies are needed to explore the precise relationship between antipsychotic drugs, glucose homeostasis, obesity and the metabolic syndrome.
Mackin
P
P
Department of Psychiatry, University of Newcastle upon Tyne, Leazes Wing, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK. paul.mackin@ncl.ac.uk
Watkinson
H M
HM
Young
A H
AH
D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005006:Ethnicity; D005260:Female; D005947:Glucose / Q000378:metabolism; D018149:Glucose Intolerance / Q000453:epidemiology*; D006706:Homeostasis / Q000187:drug effects; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D011618:Psychotic Disorders / Q000188:drug therapy*
D018687:Antidepressive Agents, Second-Generation; D014150:Antipsychotic Agents; D005947:Glucose