Metabolic syndrome in first episode schizophrenia - a randomized double-blind controlled, short-term prospective study.
BACKGROUND
Although the treatment of schizophrenia, arguably one of the most devastating diseases today, has been immensely helped by the advent of second-generation antipsychotics, they have come at a considerable cost - the metabolic syndrome (MetS). This adverse effect has been described with several antipsychotics to range between 20%-60%, at least double the prevalence in the general population.


METHODS
All consecutive patients with first episode schizophrenia at our referral psychiatric hospital were recruited in an extensive prospective randomized, double-blind controlled study including measures of waist circumference (WC), blood pressure (SBP/DBP), triglyceride (TGL), high-density lipoproteins (HDL) and fasting blood sugar (FBS) levels and randomized to receive either, haloperidol, olanzapine or risperidone. The prevalence of MetS was assessed based on two criteria- ATP IIIA and criteria of International Diabetes Federation (IDF). This was compared with a gender, age, exercise and diet matched healthy control group.


RESULTS
The analysis of 99 patients showed a prevalence of MetS as 10.1% and 18.2% as assessed by ATP IIIA and IDF criteria respectively. The prevalence of MetS in our sample of patients with schizophrenia is at least five times as high when compared to the matched healthy control group. Olanzapine had maximum prevalence of MetS at 20-25% followed by risperidone at 9-24% and haloperidol at 0-3%.


CONCLUSIONS
Metabolic syndrome is highly prevalent among treated patients with first episode schizophrenia. Early monitoring of patients on atypical antipsychotics can possibly play an important role in early detection and hence prevention of the metabolic syndrome.
Saddichha
Sahoo
S
National Tobacco Control Program, Swasthya Bhavan, Sector V, Kolkata, India. saddichha@gmail.com
Manjunatha
Narayana
N
Ameen
Shahul
S
Akhtar
Sayeed
S
D014150:Antipsychotic Agents / Q000009:adverse effects*; D001786:Blood Glucose / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008659:Metabolic Diseases / Q000139:chemically induced* / Q000453:epidemiology; D011446:Prospective Studies; D012559:Schizophrenia / Q000188:drug therapy; D014280:Triglycerides / Q000378:metabolism; D049629:Waist-Hip Ratio / Q000379:methods
D014150:Antipsychotic Agents; D001786:Blood Glucose; D014280:Triglycerides