Metabolic issues in schizophrenic patients receiving antipsychotic treatment.
Schizophrenia is a psychotic disorder with a complex pathophysiology and requires treatment that includes long term administration of antipsychotics that is said to be associated with metabolic syndrome. This study was designed to evaluate the impact of seven different antipsychotics prescribed to schizophrenic patients, on development of metabolic syndrome in the patients. A total of 210 patients with schizophrenia (30 patients in each drug therapy group) were recruited according to ICD-10 criteria and were assigned to receive the drug for 16 weeks. Measurement of anthropometric (body weight, waist circumference, blood pressure) and biochemical parameters (glucose, insulin, HOMA-IR, triglycerides, LDL, HDL) was done and the patients were subjected to ATP-III defined criteria for metabolic syndrome. Patients undergoing treatment with olanzapine were more prone to metabolic syndrome as the drug induces weight gain after 16 weeks of treatment. It also induces dyslipidemia (P < 0.001) and hyperglycemia (P < 0.01). Clozapine was found to be second most potent drug in inducing metabolic syndrome as the weight in clozapine treated patients increased after 16 weeks, along with a significant increase in glycemic (P < 0.001) and lipid parameters (P < 0.01). Aripriazole and amisulphride are comparatively safer drugs as their role in inducing metabolic abnormalities in schizophrenic patients was insignificant, although the impact of long term administration of these drugs needs to be explored. It is clear from the study that antipsychotic treatment induces metabolic syndrome so, it becomes important that the metabolic and cardiovascular risk factors should be surveillance regularly in schizophrenic patients undergoing antipsychotic treatment.
Medanta, The Medicity, Gurgaon, Haryana India.
Aditi
A
Gupta
Department of Biochemistry, NIMS Medical College, Jaipur, Rajasthan India.
Gora
G
Dadheech
Department of Biochemistry, S.M.S. Medical College, Jaipur, Rajasthan India.
Dharamveer
D
Yadav
Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, 342005 Rajasthan India.
Praveen
P
Sharma
Gautam Institute of Behavioral Sciences and Alternative Medicine, Jaipur, Rajasthan India.
Shiv
S
Gautam
ATP III; Atypical antipsychotics; HOMA-IR; Insulin resistance; Metabolic syndrome; Typical antipsychotics