title: Metabolic Abnormalities Related to Treatment With Selective Serotonin Reuptake Inhibitors in Patients With Schizophrenia or Bipolar Disorder.
abstract: OBJECTIVE
  The aim of the present study was to examine the effect of selective serotonin reuptake inhibitors (SSRIs) on cardiovascular risk factors in patients with schizophrenia or bipolar disorder.
  
  
  METHODS
  We used data from a cross-sectional study on 1301 patients with schizophrenia or bipolar disorder, of whom 280 were treated with SSRIs. The primary outcome variable was the serum concentration of total cholesterol. Secondary outcome variables were low-density lipoprotein (LDL) cholesterol, high-density lipoprotein cholesterol, triglyceride and glucose levels, body mass index, waist circumference, and systolic and diastolic blood pressure.
  
  
  RESULTS
  After adjusting for potential confounders, an SSRI serum concentration in the middle of the reference interval was associated with an increase of the total cholesterol level by 14.56 mg/dL (95% confidence interval (CI) 5.27-23.85 mg/dL, P = 0.002), the LDL cholesterol level by 8.50 mg/dL (CI 0.22-16.77 mg/dL, P = 0.044), the triglyceride level by 46.49 mg/dL (CI 26.53-66.46 mg/dL, P < 0.001) and the occurrence of the metabolic syndrome by a factor of 2.10 (CI 1.21-3.62, P = 0.008). There were also significant associations between the SSRI dose and total cholesterol and LDL cholesterol levels.
  
  
  CONCLUSIONS
  This study is the first to reveal significant associations between SSRI use and metabolic abnormalities in patients with schizophrenia or bipolar disorder. Although the effects were statistically significant, alterations were small. Thus, the clinical impact of the findings is most likely limited.
authors.affiliation: From the *Department of Psychiatry, Nord-Trøndelag Hospital Trust, Levanger Hospital, Levanger; †Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology; ‡Department of Psychiatry, St. Olavs University Hospital; §Regional Centre for Child and Youth Mental Health and Child Welfare-Central Norway, Trondheim; ‖NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo; ¶Drammen District Psychiatric Center, Clinic of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen; and #Department of Clinical Pharmacology, St. Olavs University Hospital, Trondheim, Norway.
authors.forename: Katrine Kveli
authors.initials: KK
authors.lastname: Fjukstad
authors.forename: Anne
authors.initials: A
authors.lastname: Engum
authors.forename: Stian
authors.initials: S
authors.lastname: Lydersen
authors.forename: Ingrid
authors.initials: I
authors.lastname: Dieset
authors.forename: Nils Eiel
authors.initials: NE
authors.lastname: Steen
authors.forename: Ole A
authors.initials: OA
authors.lastname: Andreassen
authors.forename: Olav
authors.initials: O
authors.lastname: Spigset
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure / Q000502:physiology*; D002784:Cholesterol / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D012559:Schizophrenia / Q000188:drug therapy* / Q000378:metabolism; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D014280:Triglycerides / Q000097:blood*; D055105:Waist Circumference / Q000502:physiology*
chemical_list: D001786:Blood Glucose; D002784:Cholesterol; D008078:Cholesterol, LDL; D008075:Lipoproteins, HDL; D017367:Selective Serotonin Reuptake Inhibitors; D014280:Triglycerides