title: Incident users of antipsychotic agents and future use of cholesterol-lowering drugs: an observational, pharmacoepidemiologic study.
abstract: OBJECTIVE
  Antipsychotic agents have serious metabolic adverse effects, among them dyslipidemia, which may necessitate secondary prophylaxis with cholesterol-lowering drugs. Second-generation antipsychotics (SGAs), particularly clozapine and olanzapine, are known to confer a higher risk of metabolic adverse effects than first-generation antipsychotics (FGAs). However, little is known regarding the real-life number of antipsychotic-treated patients receiving statins.
  
  
  METHODS
  By extracting data from the Norwegian prescription database, all patients 18-69 years old that started treatment with an antipsychotic during 2004-2012 formed the basis for analysis (n = 301,713). The primary outcome measure was the proportion of FGA and SGA users prescribed with cholesterol-lowering agent during the same period. We used Cox proportional hazards regression to evaluate the risk of redeeming a cholesterol-lowering drug for formerly antipsychotic drug-naive patients (n = 147,218).
  
  
  RESULTS
  Statin prescription rates in patients receiving antipsychotic agents were lower (5.3%) than comparable rates in studies covering the general population (34%) and lower than would be expected based on the recognized negative impact of antipsychotics on serum lipids. Statin prescription rates were affected by patient age, antipsychotic dose, and the number of antipsychotic agents prescribed, but rates were only 5% elevated in patients receiving SGAs compared to patients receiving FGAs (P = .048).
  
  
  CONCLUSIONS
  Our results may support the notion that patients treated with antipsychotic agents receive suboptimal care with regard to metabolic adverse effects.
authors: Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, 5021, Norway silje.skrede@k2.uib.no.
authors: Silje
authors: S
authors: Skrede
authors: Ingunn F
authors: IF
authors: Tvete
authors: Lars
authors: L
authors: Tanum
authors: Vidar M
authors: VM
authors: Steen
authors: Jørgen G
authors: JG
authors: Bramness
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors