Abstract
Schizophrenia is a psychotic disorder with a complex pathophysiology and requires treatment that includes long term administration of antipsychotics that is said to be associated with metabolic syndrome. This study was designed to evaluate the impact of seven different antipsychotics prescribed to schizophrenic patients, on development of metabolic syndrome in the patients. A total of 210 patients with schizophrenia (30 patients in each drug therapy group) were recruited according to ICD-10 criteria and were assigned to receive the drug for 16 weeks. Measurement of anthropometric (body weight, waist circumference, blood pressure) and biochemical parameters (glucose, insulin, HOMA-IR, triglycerides, LDL, HDL) was done and the patients were subjected to ATP-III defined criteria for metabolic syndrome. Patients undergoing treatment with olanzapine were more prone to metabolic syndrome as the drug induces weight gain after 16 weeks of treatment. It also induces dyslipidemia (P < 0.001) and hyperglycemia (P < 0.01). Clozapine was found to be second most potent drug in inducing metabolic syndrome as the weight in clozapine treated patients increased after 16 weeks, along with a significant increase in glycemic (P < 0.001) and lipid parameters (P < 0.01). Aripriazole and amisulphride are comparatively safer drugs as their role in inducing metabolic abnormalities in schizophrenic patients was insignificant, although the impact of long term administration of these drugs needs to be explored. It is clear from the study that antipsychotic treatment induces metabolic syndrome so, it becomes important that the metabolic and cardiovascular risk factors should be surveillance regularly in schizophrenic patients undergoing antipsychotic treatment.
Similar content being viewed by others
References
Gaur N, Gautam S, Gaur M, Sharma P, Dadheech G, Mishra S. The biochemical womb of schizophrenia: a review. IJCB. 2008;23(4):307–27.
Allison DB, Mentore JL, Heo M, Chandler LP, Cappelleri JC, Infante MC, et al. Antipsychotic-induced weight gain: a comprehensive research synthesis. Am J Psychiatry. 1999;156(11):1686–96.
Kaplan SI, Sadock BJ. Schizophrenia comprehensive textbook of psychiatry, vol. 1. 6th ed. Baltimore: Williams and Wilkins; 1989. p. 699–815.
Garry R. Schizophrenia, antipsychotics, and the metabolic syndrome: is there a silver lining? Am J Psychiatry. 2006;163:1132–4.
Homel P, Casey D, Allison DB. Changes in body mass index for individuals with and without schizophrenia 1987–1996. Schizophr Res. 2002;55(3):277–84.
Davidson S, Judd F, Jolley D, Hocking B, Thompson S, Hyland B. Cardiovascular risk factors for people with mental illness. Aust N Z J Psychiatry. 2001;35(2):196–202.
Deglin JH, Vallerand AH, Sanoski CA. Davis drug guide. 10th ed. Philadelphia: FA Davis; 2007.
Masand PS. Relative weight gain among antipsychotics. J Clin Psychiatry. 1999;60:706–8.
Trinder P. Determination of glucose in blood using glucose oxidase with an alternative glucose acceptor. Ann Clin Biochem. 1969;6:24–7.
Herbert K. Lipids: in clinical chemistry. In: Kaplan LA, Pesce AJ, editors. Theory, analysis and co-relation. Toronto: CV Mosby; 1984. p. 1182–230.
Okada M, Matsui H, Ito Y, Fujiwara A. Direct measurement of HDL cholesterol: method eliminating apolipoprotein E-rich particles. J Clin Lab Anal. 2001;15:223–9.
Yang X, Guo A, Wu L, Deng A, Yang H. Chemiluminiscent immunoassay for insulin. Hua Xi Yi Ke Da Xue Xue Bao. 1991;22(3):259–61.
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Teacher DF, Turner RC. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentration in man. Diabetologia. 1985;28:412–9.
Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of metabolic syndrome. Circulation. 2005;112:2735–52.
Osby U, Correia N, Brandt L. Mortality and causes of death in schizophrenia in Stockholm Country Sweden. Schizophr Res. 2000;45:21–8.
Heiskanen T, Niskanen L, Lytikkanen R, Saarinen PL, Hintikka J. Metabolic syndrome in patients with schizophrenia. J Clin Psychiatry. 2003;64:575–9.
Elligord VL, Miller DD, Taylor SF. Dietary lifestyle and pharmacogenetic factors associated with arteriole endothelial dependent vasodilatations in schizophrenic patients. Schizopher Res. 2008;98:47–54.
Bray GA. Afferent signals regulating food intake. Proc Nutr Soc. 2000;59:373–84.
Silvestee JS, Prous J. Association of genetic variant of histamine H1 and muscarinic M3 receptors with BMI and HbA1c values in patients with antipsychotic medication. Exp Clin Pharmacol. 2005;27:289–304.
Dweyer DS, Donohoe D. Induction of hyperglycemia in mice with atypical antipsychotic drug that inhibit glucose uptake. Pharmacol Biochem Behav. 2003;75:255–60.
Walton C, Lees B, Crook D. Body fat distribution rather than overall adiposity, influences serum lipids and lipoprotein in healthy men independently of age. Am J Med. 1995;99:459–64.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gupta, A., Dadheech, G., Yadav, D. et al. Metabolic Issues in Schizophrenic Patients Receiving Antipsychotic Treatment. Ind J Clin Biochem 29, 196–201 (2014). https://doi.org/10.1007/s12291-013-0415-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12291-013-0415-z