Metabolic risk in selected second-generation antipsychotics

Many studies have reported higher incidence of metabolic abnormalities in patients receiving antipsychotic medications than in general population.

The objective of our study was to determine the prevalence of metabolic syndrome in a group of patients receiving long-lasting antipsychotic treatment and also whether the cardiovascular risk among different second-generation antipsychotics varies.

Our study group consisted of 71 patients who were on antipsychotic monotherapy for at least 12 months. In each patient, fasting plasma glucose, HDL cholesterol, triglycerides, liver enzymes, bilirubin and plasma immunoreactive insulin levels were examined. We measured body weight, height, body mass index, waist circumference and body fat percentage together with blood pressure and heart rate. We assessed metabolic syndrome prevalence in the study group and correlations among its components as well as between them and other variables. The data were processed by statistics programme STATISTICA 8.0. For detection of correlations Spearman's rank correlation test was used.

The prevalence of metabolic syndrome in our sample reached 41%. The highest prevalence rate of 50% was detected in the olanzapine subgroup. Identical prevalence of 40% was observed in quetiapine and risperidone subgroups. The lowest prevalence of 25% and 31% was observed in sertindol and amisulpirid subgroup, respectively. The prevalence rate of metabolic syndrome in men was 51% compared to 34% in women.

According to metabolic syndrome prevalence rates olanzapine appears to be associated with the highest cardiovascular risk, amisulpirid and sertindol appear to be much safer (Tab. 2, Ref. 13).