title: Changes in body mass and metabolic profiles in patients with first-episode schizophrenia treated for 12 months with a first-generation antipsychotic.
abstract: OBJECTIVE
  To assess changes in body mass and metabolic profiles in patients with first-episode schizophrenia receiving standardised, assured treatment and to identify predictors and moderators of the effects.
  
  
  METHODS
  We investigated the changes in body mass, fasting blood glucose and lipids in 107 largely antipsychotic naïve, first-episode schizophrenia patients who were treated according to a standard algorithm with long-acting injectable flupenthixol decanoate over 12 months.
  
  
  RESULTS
  Eighty-three (78%) participants completed the 12 months of treatment, and 104 (97%) received 100% of the prescribed injections during their participation. There were significant increases in BMI (P<.0001), waist circumference (P=0.0006) and triglycerides (P=0.03) and decrease in HDL (P=0.005), while systolic (P=0.7) and diastolic blood pressure (P=0.8), LDL (P=0.1), cholesterol (P=0.3), and glucose (P=0.9) values did not change over time. The triglyceride: HDL ratio increased by 91%. Change in BMI was only correlated with change in triglycerides (P=.008). The only significant predictor of BMI increase was non-substance abuse (P=.002).
  
  
  CONCLUSIONS
  The risks of weight gain and metabolic syndrome associated with antipsychotic treatment in first-episode schizophrenia are not restricted to second generation antipsychotics. This is a global problem, and developing communities may be particularly susceptible.
authors.affiliation: Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa. Electronic address: bonga@sun.ac.za.
authors.forename: B
authors.initials: B
authors.lastname: Chiliza
authors.affiliation: Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
authors.forename: L
authors.initials: L
authors.lastname: Asmal
authors.affiliation: Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
authors.forename: P
authors.initials: P
authors.lastname: Oosthuizen
authors.affiliation: Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
authors.forename: E
authors.initials: E
authors.lastname: van Niekerk
authors.affiliation: Division of Chemical Pathology, Faculty of Medicine and Health Sciences, Tygerberg, South Africa.
authors.forename: R
authors.initials: R
authors.lastname: Erasmus
authors.affiliation: Centre for Statistical Consultation, Stellenbosch University, Stellenbosch, South Africa.
authors.forename: M
authors.initials: M
authors.lastname: Kidd
authors.affiliation: Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, New York, USA.
authors.forename: A
authors.initials: A
authors.lastname: Malhotra
authors.affiliation: Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
authors.forename: R
authors.initials: R
authors.lastname: Emsley
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D005475:Flupenthixol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000139:chemically induced*; D055442:Metabolome; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy*; D013019:South Africa; D014280:Triglycerides / Q000097:blood*; D015430:Weight Gain / Q000187:drug effects
chemical_list: D014150:Antipsychotic Agents; D015415:Biomarkers; D001786:Blood Glucose; D014280:Triglycerides; C007761:flupenthixol decanoate; D002784:Cholesterol; D005475:Flupenthixol
keywords: Developing countries; First-episode schizophrenia; Flupenthixol; Metabolic syndrome; Weight gain