title: Typical and atypical antipsychotics differentially affect long-term incidence rates of the metabolic syndrome in first-episode patients with schizophrenia: a retrospective chart review.
abstract: The presence of the metabolic syndrome (MetS) is an important risk factor for cardiovascular disease and diabetes. There are limited data on the prevalence of MetS in patients with schizophrenia at the onset of the disorder and specifically no data on patients treated in the era when only first-generation antipsychotics were available.
  
  
  METHODS
  Data from a historic cohort of consecutively admitted first-episode patients with schizophrenia treated with first-generation antipsychotics (FGAs) were compared with an age and sex matched series of consecutive first-episode patients treated only with second-generation antipsychotics (SGAs). Rates of MetS were compared at baseline and after on average 3 years of treatment exposure.
  
  
  RESULTS
  At first episode there was no difference in the prevalence of MetS between the historic and the current cohort. Rates of MetS increased over time in both groups, but patients started on SGAs had a three times higher incidence rate of MetS (Odds Ratio 3.6, CI 1.7-7.5). The average increase in weight and body mass index was twice as high in patients started on SGA. The difference between the FGA and SGA group was no longer significant when patients started on clozapine and olanzapine were excluded.
  
  
  CONCLUSIONS
  Rates of MetS at the first episode of schizophrenia today are not different from those of patients 15 to 20 years ago. This finding counters the notion that the high rates of metabolic abnormalities in patients with schizophrenia currently reported are mainly due to lifestyle changes over time in the general population. Some SGAs have a significantly more negative impact on the incidence of MetS compared to FGAs in first-episode patients.
authors.affiliation: University Psychiatric Center Katholieke Universiteit Leuven, Leuvense Steenweg 517, 3070 Kortenberg, Belgium. marc.de.hert@uc-kortenberg.be
authors.forename: Marc
authors.initials: M
authors.lastname: De Hert
authors.forename: Vincent
authors.initials: V
authors.lastname: Schreurs
authors.forename: Kim
authors.initials: K
authors.lastname: Sweers
authors.forename: Dominique
authors.initials: D
authors.lastname: Van Eyck
authors.forename: Linda
authors.initials: L
authors.lastname: Hanssens
authors.forename: Sebastjan
authors.initials: S
authors.lastname: Sinko
authors.forename: Martien
authors.initials: M
authors.lastname: Wampers
authors.forename: Andre
authors.initials: A
authors.lastname: Scheen
authors.forename: Joseph
authors.initials: J
authors.lastname: Peuskens
authors.forename: Ruud
authors.initials: R
authors.lastname: van Winkel
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000145:classification*; D002593:Cetrimonium Compounds; D015331:Cohort Studies; D004338:Drug Combinations; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008659:Metabolic Diseases / Q000139:chemically induced* / Q000453:epidemiology*; D009226:Myristates; D009539:Nicotinic Acids; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy*; D012841:Simethicone; D013229:Stearic Acids
chemical_list: D014150:Antipsychotic Agents; D002593:Cetrimonium Compounds; D004338:Drug Combinations; D009226:Myristates; D009539:Nicotinic Acids; D013229:Stearic Acids; C058060:Prevasore; D012841:Simethicone