Increased dyslipidemia in schizophrenic outpatients using new generation antipsychotics.
OBJECTIVE
First and second generation antipsychotics are associated with metabolic disturbances. A cross-sectional study was designed to follow outpatients at the Schizophrenia and Dementia Program at a major teaching hospital in Porto Alegre, Brazil (Hospital de Clínicas de Porto Alegre) in order to verify whether second generation antipsychotics were associated with higher glucose and lipid levels regardless of age and gender.


METHODS
Four metabolic parameters (cholesterol and fractions, glucose and triglycerides) and anthropometric measures were obtained from 124 consecutive adult outpatients diagnosed with schizophrenia by DSM-IV and ICD-10 with the Operational Criteria Checklist for Psychotic Disorders system using the same antipsychotic drug for at least 9 weeks.


RESULTS
Most patients had elevated BMI (76.6%) and dyslipidemia (84.7%). Clozapine users had lower HDL levels compared to first generation antipsychotics users. Both groups had elevated body mass index (p = 0.033; OR = 3.3; 95%CI = 1.1-9.8) and second generation antipsychotics (p = 0.021; OR = 3.5; 95%CI = 1.1-11.2) showed significant effect, adjusted for age and gender in the logistic regression for dyslipidemia, and significant age effect for hyperglycemia (p = 0.030; OR = 1.1; 95%CI = 1.0-1.1).


CONCLUSIONS
There was statistically significant association between the use of second generation antipsychotics and dyslipidemia. It raises the issue of increased vulnerability of second generation antipsychotics-treated patients, regardless of age, as well as the need for assertive treatment for overweight and dyslipidemia in schizophrenia in order to reduce the risk of diabetes and cardiovascular disease.
Leitão-Azevedo
Carmen Lúcia
CL
Psychiatry Graduation Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. nicao@terra.com.br
Guimarães
Lísia Rejane
LR
de Abreu
Martha Guerra Belmonte
MG
Gama
Clarissa Severino
CS
Lobato
Maria Inês
MI
Belmonte-de-Abreu
Paulo Silva
PS
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects*; D015415:Biomarkers; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood*; D050171:Dyslipidemias / Q000097:blood / Q000139:chemically induced* / Q000150:complications; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000209:etiology; D012559:Schizophrenia / Q000188:drug therapy*; D012737:Sex Factors; D014280:Triglycerides / Q000097:blood*
D014150:Antipsychotic Agents; D015415:Biomarkers; D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol