Antipsychotic drugs and associated metabolic disorders
Kolcsár Melinda, Nagy Réka, Nagy Imre, László Annamária & Kun Imre Zoltán
Obesity is a major contributor to a range of metabolic disorders responsible for much of the medical morbidity and mortality. Increasing numbers of reports concerning not only obesity, but diabetes, hyperglycaemia and lipid dysregulation in patients treated with antipsychotics have raised concerns about a possible association between these metabolic effects and treatment with these medications. The objective of our study was to investigate the prevalence of obesity and other metabolic disorders in young patients treated with different antipsychotics and in the age matched general population. Antropometric and metabolic data of the patients treated with psychotropics, hospitalized in the Endocrinology Clinic, Tg. Mures, between years 20012005 were compared with the data of persons selected among patients hospitalized in the same clinic and period, without psychotropic drug use. The frequency of patients treated with antipsychotics was 10.92% (4.33% typical antipsychotics and 6.59% atypical antipsychotics) with 43.1±13.6 years of mean age. In this patients the prevalence of obesity, elevated total cholesterol and triglyceride level was significantly higher than in the control group. The blood sugar didnt present difference between the two groups, but measuring HOMA-IR in 25 patients treated with atypical psychotropics and 20 other persons without treatment with psychotropic drug we found a significant difference between them. We concluded that a complete metabolic syndrome (MS) was present in 34.2% of the patients treated with antipsychotic drugs, while the frequency of MS was only 18.7% in the age matched patients group without any psychotropic drug use. Atypicial antipsychotics causes the most severe metabolic disorders in association with a significantly elevated prolactin level, when compared with the control group. The choice of a second generation antipsychotic for a given patient depends on many factors. The likehood of developing severe metabolic disease should also be an important consideration.