Research view
Title: | Metabolic dysfunction related to typical and atypical antipsychotics in drug-naive patients with nonaffective psychosis: a prospective comparative study |
Author: | Tarek Asaad, Marwa A. Meguid, Marwa El Missiry, Rami Ali, Rasha E. Bassim and Sameh Taha |
Abstract: |
Background
Metabolic syndrome induced by antipsychotic (AP) drugs is commonly encountered in
patients with nonaffective psychosis. Epidemiological studies report that 52% of patients
with severe mental illness such as schizophrenia, schizoaffective disorder, bipolar
disorder, and depression have metabolic syndrome compared with only 23–25% of the
general population and thus have a markedly decreased life expectancy.
Aim
The study aimed to compare the effect of typical and atypical APs on different metabolic
parameters in newly diagnosed drug-naive patients with psychotic disorders for a period of
12 weeks,which were divided into three follow-up visits, and clarify the associated risk factors.
Patients and methods
A convenient sample of 80 patients 18–50 years of age, of both sexes, from both
inpatient and outpatient departments of the Institute of Psychiatry were screened for
possible inclusion in the study. All patients were interviewed using SCID-I. Patients
fulfilling the DSM-IV diagnostic criteria for schizophrenia, delusional disorder, brief
psychotic disorder, and/or schizophreniform disorder, who had never been treated with
psychotropic medication, and who had no comorbid medical conditions were included.
Using computerized randomization, patients were assigned to two groups: group I
received typical APs and group II received atypical APs. Demographic and clinical data
were collected and anthropometric measurements were taken. Finally, laboratory
analysis was performed for assessment of fasting blood glucose and lipid profile.
Results
The mean age of the patients was 26.03± 6.53 years in group I and 28.48 ±6.29
years in group II. Group I patients were prescribed haloperidol, trifluoperazine, and
flupenthixol, whereas group II patients were prescribed risperidone, olanzapine, and
quetiapine. With regard to weight gain, patients in both groups were found to gain
weight; however, it was more evident in patients given atypical APs, with a statistically
significant difference across visits. Fasting blood glucose level increased significantly
across visits in each group, but a comparison between the two groups did not show
statistical significance.With regard to lipid profiles, cholesterol levels increased across
visits and showed a statistically significant difference in visit 3; serum triglycerides and
low-density lipoprotein increased as well but with no statistical significance; highdensity
lipoprotein decreased across visits but with no statistical significance.
Conclusion
AP medications, although providing a tremendous change in the lives of patients and
giving them a better future, have imposed more of a burden on their metabolic profiles.
This is especially true of atypical compounds.
Keywords:
atypical anti-psychotic, drug- naive patients,
metabolic dysfunction, non-affective psychosis, typical anti-psychotic
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Journal: | Middle East Curr Psychiatry 24:93–101 |
Text: | |
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