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THE CORRELATION BETWEEN METABOLIC EFFECTS AND ANTIPSYCHOTIC THERAPY - Corelatii intre efectele metabolice si tratamentul antipsihotic - Catalina Crisan, Corina Marginean, Liana Fodoreanu, Daniela Ponta

 Abstract

The side effects profile of antipsychotics represents one of the most important criteria for the compliance to treatment of psychiatric patients. The metabolic side effects are due to a number of factors: the type of antipsychotic (classical or atypical), the dose of the drug and the individual response to treatment.

Aim of study: To evaluate the metabolic effects due to antipsychotic treatment in psychotic patients.

Materials and methods: 59 male patients admitted in First Psychiatric Clinic Cluj-Napoca between June 2006 and April 2007 and diagnosed according to ICD-10 criteria with different types of schizophrenia (paranoid schizophrenia, disorganized schizophrenia, undifferentiated schizophrenia), schizoaffective disorder or acute psychotic disorder with or without schizophrenic symptoms participated in the study. Patients’ socio-demographic, clinical and treatment information (age, age at onset of illness, duration of illness, type and doses of antipsychotic and associated medication) were collected. Cholesterol, triglycerides, lipids and plasma glucose levels, waist circumference, BMI (body mass index) and weight were determined at the beginning of treatment and after 4 weeks.

Results : 16/59 (27,11%) patients were treated with Haloperidol (mean dose 11,68 mg/day), 16/59 (27,11%) with Olanzapine (mean dose 19,37 mg/day), 12/59 (20,33%) with Amisulpride (mean dose 683,33 mg/day), 9/59 (15,24%) with Quetiapine (mean dose 666,66 mg/day) and 6/59 (10,17%) with Risperidone Consta (35,41 mg/2 weeks). 8 patients (2 treated with Haloperidol and 6 with atypical antipsychotics) had high levels of cholesterol (>200 mg/dl). 13 patients (3 treated with Haloperidol and 10 with SGAs-second generation antipsychotics) had higher mean triglyceridaemia (>150 mg/day). Values of total lipids over 800 mg/day were observed in 5 patients (2 treated with FGA-first generation antipsychotics, Haloperidol and 3 with SGAs). 5 of 59 patients, all treated with atypical antipsychotics had higher mean glycaemia (>110 mg/day). 4 patients, one treated with Haloperidol had waist circumference over 102 cm. 14 patients (2 treated with Haloperidol and 12 with atypical antipsychotics had body mass index over 25 kg/m²).

Conclusions: The rate of obesity and metabolic disorders observed in this study were higher in patients treated with second generation antipsychotics.

Key words: antipsychotics, metabolism, schizophrenia