Antipsychotic-related metabolic syndrome varies between psychiatric disorders

Antipsychotic-associated metabolic syndrome is more common in patients with schizophrenia and bipolar disorder than in those treated with the medications for other psychiatric illnesses, a new study has concluded. Research suggests that people with serious mental disorders have a higher risk cardiovascular disease, partly attributable to lifestyle factors. However, they also have an increased frequency of metabolic disorders. There has also been renewed attention on physical comorbidities associated with psychiatric disorders and the use of antipsychotic medications. While data exists on the prevalence of metabolic syndrome in people with schizophrenia and related disorders treated with antipsychotic medications, little information exists on metabolic syndrome in people with bipolar disorder, dementia, organic psychosis or secondary anxiety disorders. This cross-sectional analysis compared the prevalence of metabolic syndrome in outpatients treated with antipsychotic medication in a primary healthcare setting. There were 742 patients treated with first- or second-generation antipsychotics for at least three months, and about 85,000 controls who had not been exposed to antipsychotics. All components of the metabolic syndrome, except for hypertension, were significantly more common in the treatment group than the control subjects (27% versus 14%). Specifically, there were higher triglyceride concentrations (136.6 mg/dL versus 119.3 mg/dL), as were high-density lipoprotein cholesterol levels (43.7 mg/dL versus 47.2 mg/dL) and body mass index (28.9 versus 27.4 kg/m2). The prevalence of obesity was significantly higher among patients receiving antipsychotic medication (38% versus 27%). A sub-group analysis by treatment indication revealed that the prevalence of metabolic syndrome was significantly higher among patients with schizophrenia and bipolar disorder than control subjects. In contrast, the prevalence of metabolic syndrome in those whose principal indication was dementia or other disorders (including autism, psychological disorders, borderline personality disorders and resistant major depressive disorders) was not significantly more prevalent after correcting for age and gender. “Regardless of the effect of life style and health-damaging habits, attention should also focus on the role of the drugs used as treatment, some of which have been shown to exert a direct influence upon weight gain and lipid and carbohydrate metabolic disorders which may play an important role in the development of metabolic syndrome,” the authors concluded. Reference Sicras-Mainar, A. Blanca-Tamayo, M. et al. 2007, ‘Metabolic syndrome in outpatients receiving antipsychotic therapy in routine clinical practice: A cross-sectional assessment of a primary health care database.’ European Psychiatry published online....