Metabolic disturbances during treatment with second generation antipsychotics

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Second generation antipsychotics (SGA) cause side effects through weight gain, dyslipidemias (cholesterolemia, hypertriglyceridemia) as well as affected glucose homeostasis in terms of hyperglycemia,insulin resistance and the incidence of type 2 diabetes mellitus. The aim of this study was to investigate metabolic changes in patients treated with SGA. Materials and methods: This was a prospective study of 50 patients treated with SGA (olanzapine, clozapine, risperidone, quetiapine, aripiprazole) at the PHI University Clinic of Psychiatry who met the relevant ICD-10 criteria. The following parameters were monitored: history and clinical examination, blood pressure and pulse, height, weight, body mass index (BMI), Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression Scale (CGI-S), dose of prescribed SGA,as well as: fasting glycemia, lipid status, HDL, LDL, glycosylated hemoglobin (HgA1C). The parameters were determined at the beginning and after three months of treatment. Results: The subjects in terms of the criteria of metabolic syndrome were: 64% with a larger waist circumference, 53.2% with an increase in systolic and/or diastolic blood pressure, 31.3% with a BMI>30, and 39% with an increase in glycaemia and reduced HDL values ​​at 23.4%. Also,18% of the respondents met three or more criteria. Statistical analysis of the differences in the analyzed parameters showed statistically significant differences for the CGI-S score (p = 0.00007) and for the diastolic pressure (p = 0.038). Correlation of equivalent doses of SGA with BMI (r = -0.637) was obtained. Discussion: The study confirmed presence of metabolic disorders in patients treated with SGA. Although there was no significant difference of metabolic syndrome parameters in relation to the general population, a correlation with BMI has been established. Conclusion: This study showed that patients treated with second-generation antipsychotics should be monitored during their treatment for the parameters of the metabolic syndrome, particularly BMI.

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