Fat Distribution in Schizophrenia Patients: A Pilot Study Comparing First- and Second-Generation Antipsychotics

Area of Science:

• Endocrinology
• Psychiatry
• Metabolic Health

Background:

• Second-generation antipsychotics (SGAs) reduce neurologic toxicity but increase weight gain and obesity.
• Understanding the metabolic impact of different antipsychotic classes is crucial for patient management.

Purpose of the Study:

• To compare the effects of first-generation antipsychotics (FGAs) and SGAs on body fat and metabolic parameters in patients with schizophrenia.

Main Methods:

• Pilot study comparing men with schizophrenia treated with FGAs (n=5) versus SGAs (n=9).
• Evaluated psychiatric symptoms, adverse effects, body composition, glucose, insulin, adipokines, and inflammatory markers.
• Statistical analysis using Student's t-test.

Main Results:

• FGAs associated with lower mean body mass index (BMI) (P=0.06) and significantly lower waist/height ratio (P=0.036).
• FGAs treatment linked to reduced android fat mass index (P=0.03).
• Significantly lower peripheral insulin resistance (Homeostasis Model Assessment for insulin resistance) observed with FGAs (P=0.014).

Conclusions:

• FGAs may be associated with decreased peripheral insulin resistance and less abdominal fat accumulation compared to SGAs.
• Further research with larger cohorts is needed to confirm these metabolic findings.