title: Metabolic syndrome in schizophrenia - who is more to blame: FGA polypharmacy or clozapine monotherapy?
abstract: BACKGROUND
  To establish the prevalence of metabolic syndrome and its parameters in group of patients with schizophrenia in polypharmacy - receiving first generation antipsychotics versus clozapine alone treated group.
  
  
  METHODS
  48 outpatients with schizophrenia divided into two groups: the first group of 21 patients in polypharmacy with first generation antipsychotics, and the second group of 27 patients treated with clozapine alone were assessed for the presence of metabolic syndrome. We used logistic regression models to assess the relationship between metabolic syndrome and antipsychotic therapy, gender and age.
  
  
  RESULTS
  Metabolic syndrome was found in 52.1% of all subjects. Compared to first generation antipsychotics polypharmacy, the monopharmacy with clozapine was associated with elevated rates of metabolic syndrome (28.6% vs. 70.4%, p=0.004). With regard to particular parameters of metabolic syndrome, the elevated plasma triglycerides were significantly more present in subjects within Clozapine group (p=0.03). Logistic regression analysis showed that female gender (p=0.004), and clozapine treatment (p=0.005) were significantly associated with metabolic syndrome.
  
  
  CONCLUSIONS
  Compared to polypharmacy with first generation antipsychotics, the higher prevalence of metabolic syndrome is found in patients treated with Clozapine alone. The most prevalent metabolic disorder is dyslipidemia.
authors.affiliation: Department of Psychiatry, University Clinical Center Tuzla, Solina b.b., 75000 Tuzla, Bosnia and Hercegovina, dr.softic@gmail.com.
authors.forename: Rusmir
authors.initials: R
authors.lastname: Softic
authors.forename: Alija
authors.initials: A
authors.lastname: Sutovic
authors.forename: Esmina
authors.initials: E
authors.lastname: Avdibegovic
authors.forename: Enes
authors.initials: E
authors.lastname: Osmanović
authors.forename: Elvir
authors.initials: E
authors.lastname: Bećirović
authors.forename: Mitra Mirković
authors.initials: MM
authors.lastname: Hajdukov
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003024:Clozapine / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000139:chemically induced* / Q000453:epidemiology*; D008875:Middle Aged; D019338:Polypharmacy; D015995:Prevalence; D012559:Schizophrenia / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents; D003024:Clozapine