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Current Psychopharmacology

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ISSN (Print): 2211-5560
ISSN (Online): 2211-5579

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Research Article

A Study of Metabolic Syndrome in Patients on Risperidone

Author(s): Ajay Thangraj, Nimesh G. Desai and Vijender Singh*

Volume 9, Issue 3, 2020

Page: [218 - 227] Pages: 10

DOI: 10.2174/2211556009666200316143613

Price: $65

Abstract

Background: Novel antipsychotics are superior to conventional antipsychotics, as they significantly reduce both positive and negative symptoms of schizophrenia and have lower risk of extra pyramidal syndrome (EPS). However, these drugs cause significant metabolic side effects.

Objective: This study was carried out to assess the hospital prevalence of metabolic syndrome (MetS) and metabolic profile related to use of oral risperidone which is one of the most commonly used atypical antipsychotics.

Methods: A cross-sectional study was carried out on a period sample of 6 months, to study the hospital prevalence and profile of MetS in adult patients on oral risperidone. Data was collected from pharmacy dispensing records, patients’ case record files, and subsequently patients were contacted telephonically and called to participate in this study.

Results: Hospital prevalence of MetS was found to be 12.1% (13 out of 107) by NCEP ATP III criteria and 14.9% (16 out of 107) by IDF criteria in patients (aged 20 to 40 years) on risperidone. Ninety one patients (85%) of the sample were found to be in Overweight category and Central Obesity was found in 82(76.6%) patients. Twenty three (21.4%) of the patients had increased triglyceride (TG) levels. Out of the 16 patients with MetS, 11(68.75%) of them had total duration of illness (TDI) of >4 years, 11(68.75%) were in 30-40 years age group, 13 (81.25%) of them had continued illness or they were in partial remission, 11 (68.75%) of them were already exposed to any antipsychotics other than risperidone, 6(37.5%) of them were having diabetes mellitus (DM) in one parents.

Conclusion: This study reported the hospital prevalence of MetS as 14.9% (IDF criteria) in young adult patients on oral risperidone. The triglyceride levels and central obesity was also found to be higher in patients, who otherwise had low prevalence of MetS.

Keywords: Atypical antipsychotics, cross-sectional study, hospital prevalence, metabolic syndrome, oral risperidone, young adults.

Graphical Abstract

[1]
Cornier MA, Dabelea D, Hernandez TL, et al. The metabolic syndromeEndocr Rev 2008; 29(7): 777-822
[http://dx.doi.org/10.1210/er.2008-0024] [PMID: 18971485]
[2]
Alberti KG, Zimmet P, Shaw J. Metabolic syndrome--a new world-wide definition. A consensus statement from the International Diabetes Federation. Diabet Med 2006; 23(5): 46980.
[http://dx.doi.org/10.1111/j.1464-5491.2006.01858.x ] [PMID: 16681555]
[3]
Mozumdar A, Liguori G. Persistent increase of prevalence of metabolic syndrome among U.S. adults: NHANES III to NHANES 1999-2006. Diabetes Care 2011; 34(1): 216-9.
[http://dx.doi.org//10.2337/dc10-0879] [PMID: 20889854]
[4]
Danaei G, Finucane MM, Lin JK, et al. Global burden of metabolic risk factors of chronic diseases collaborating group (blood pressure). National, regional, and global trends in systolic blood pressure since 1980: systematic analysis of health examination surveys and epidemiological studies with 786 country-years and 5•4 million participants. Lancet 2011; 377(9765): 56877.
[http://dx.doi.org/10.1016/S0140-6736(10)62036-3 ] [PMID: 21295844]
[5]
Farzadfar F, Finucane MM, Danaei G, et al. Global burden of metabolic risk factors of chronic diseases collaborating group (cholesterol). National, regional, and global trends in serum total cholesterol since 1980: systematic analysis of health examination surveys and epidemiological studies with 321 country-years and 3•0 million participants. Lancet 2011; 377(9765): 57886.
[http://dx.doi.org/10.1016/S0140-6736(10)62038-7 ] [PMID: 21295847]
[6]
Papanastasiou E. Interventions for the metabolic syndrome in schizophrenia: a review. Ther Adv Endocrinol Metab 2012; 3(5): 141-62.
[http://dx.doi.org/10.1177/2042018812458697 ] [PMID: 23185687]
[7]
Chou IJ, Kuo CF, Huang YS, et al. Familial aggregation and heritability of schizophrenia and coaggregation of psychiatric illnesses in affected families. Schizophr Bull 2017; 43(5): 1070-8..
[http://dx.doi.org/10.1093/schbul/sbw159] [PMID: 27872260]
[8]
Saha S, Chant D, McGrath J. A systematic review of mortality in schizophrenia: is the differential mortality gap worsening over time? Arch Gen Psychiatry 2007; 64(10)112331
[http://dx.doi.org/10.1001/archpsyc.64.10.1123 ] [PMID: 17909124]
[9]
Tandon R, Nasrallah HA, Keshavan MS. Schizophrenia, “just the facts” 4. Clinical features and conceptualization. Schizophr Res 2009; 110(1-3): 123.
[http://dx.doi.org/10.1016/j.schres.2009.03.005 ] [PMID: 19328655]
[10]
Hansen T, Ingason A, Djurovic S, et al. At-risk variant in TCF7L2 for type II diabetes increases risk of schizophrenia. Biol Psychiatry 2011; 70(1): 5963.
[http://dx.doi.org/10.1016/j.biopsych.2011.01.031 ] [PMID: 21414605]
[11]
Correll CU, Frederickson AM, Kane JM, Manu P. Metabolic syndrome and the risk of coronary heart disease in 367 patients treated with second-generation antipsychotic drugs. J Clin Psychiatry 2006; 67(4): 575-83.
[http://dx.doi.org/10.4088/JCP.v67n0408] [PMID: 16669722]
[12]
Parks J, Svendsen D, Singer P, Foti M. Morbidity and mortality in people with serious mental illness national association of state mental health program Directors (NASMHPD). Med Direct Council 2006; 25(4): 1-87.
[13]
Jin H, Folsom D, Sasaki A, et al. Increased Framingham 10-year risk of coronary heart disease in middle-aged and older patients with psychotic symptoms. Schizophr Res 2011; 125(2-3): 2959.
[http://dx.doi.org/10.1016/j.schres.2010.10.029 ] [PMID: 21093219]
[14]
Pillinger T, McCutcheon RA, Vano L, et al. Comparative effects of 18 antipsychotics on metabolic function in patients with schizophrenia, predictors of metabolic dysregulation, and association with psychopathology: a systematic review and network meta-analysis. Lancet Psychiatry 2020; 7(1): 64-77.
[http://dx.doi.org/10.1016/S2215-0366(19)30416-X ] [PMID: 31860457]
[15]
Lempiäinen P, Mykkänen L, Pyörälä K, Laakso M, Kuusisto J. Insulin resistance syndrome predicts coronary heart disease events in elderly nondiabetic men. Circulation 1999; 100(2): 1238.
[http://dx.doi.org/10.1161/01.CIR.100.2.123 ] [PMID: 10402440]
[16]
Ford MI. Flegal Km, Cowie CC, Eberhardt MS, Goldstein DE, Little R. Prevalence of diabetes, impaired fasting glucose tolerance in US adults: The third national health and nutrition examination survey. Diabetes Care 2005; 21: 518-24.
[17]
Isomaa B, Almgren P, Tuomi T, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome.Diabetes Care 2001; 24(4): 683-9..
[http://dx.doi.org//10.2337/diacare.24.4.683] [PMID: 11315831]
[18]
Albrink MJ, Meigs JW. The relationship between serum triglycerides and skinfold thickness in obese subjects. Ann N Y Acad Sci 1965; 131(1): 673-83.
[http://dx.doi.org/10.1111/j.17496632.1965.tb34830.x ] [PMID: 5217001]
[19]
Gavin P. Genetic dissection of atypical antipsychotics-weight gain: novel preliminary data on pharmacogenetic puzzle. J Clin Psychiatry 2006; 62: 45-66.
[20]
Haddad P. Reversal of Antipsychotics induced weight gain. J Psychopharmacol 2005; 19: 16-27.
[http://dx.doi.org/10.1177/0269881105058378 ] [PMID: 16280334]
[21]
World Health Organization. The ICD‐10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. Geneva 1992.
[22]
Gautam S, Meena PS. 2011.Drug-emergent metabolic syndrome in patients with schizophrenia receiving atypical (second-generation) antipsychotics. Indian J Psychiatry 2011; 53(2): 128-33..
[http://dx.doi.org/10.4103/0019-5545.82537] [PMID: 21772644]
[23]
Wysokiński A, Kowman M, Kłoszewska I. The prevalence of metabolic syndrome and Framingham cardiovascular risk scores in adult inpatients taking antipsychotics - a retrospective medical records review. Psychiatr Danub 2012; 24: 314-22.
[24]
Padmavati R, McCreadie RG, Tirupati S. Low prevalence of obesity and metabolic syndrome in never-treated chronic schizophrenia. Schizophr Res 2010; 121(1-3): 199-202.
[http://dx.doi.org/10.1016/j.schres.2010.05.010 ] [PMID: 20538429]
[25]
Tirupati S, Chua LE. Obesity and metabolic syndrome in a psychiatric rehabilitation service. Aust N Z J Psychiatry 2007; 41(7): 606-10.
[http://dx.doi.org/10.1080/00048670701392841 ] [PMID: 17558623]
[26]
Subramaniam M, Lam M, Guo ME, et al. Body mass index, obesity, and psychopathology in patients with schizophrenia. J Clin Psychopharmacol 2014; 34(1): 40-6.
[http://dx.doi.org/10.1097/JCP.0000000000000058 ] [PMID: 24346756]
[27]
Yan H, Chen JD, Zheng XY. Potential mechanisms of atypical antipsychotic-induced hypertriglyceridemia. Psychopharmacology (Berl) 2013; 229(1): 1-7.
[http://dx.doi.org/10.1007/s00213-013-3193-7 ] [PMID: 23832387]
[28]
Newcomer JW, Haupt DW, Fucetola R, et al. Abnormalities in glucose regulation during antipsychotic treatment of schizophrenia.Arch Gen Psychiatry 2002; 59(4): 337-45..
[http://dx.doi.org/10.1001/archpsyc.59.4.337] [PMID: 11926934]
[29]
Kaushal J, Bhutani G, Gupta R. Comparison of fasting blood sugar and serum lipid profile changes after treatment with atypical antipsychotics olanzapine and risperidone. Singapore Med J 2012; 53(7): 488-92.
[PMID: 22815019]
[30]
Dos Santos-Junior Amilton, Barbosa HT, Maricilda PD-M et al. Pharmacogenetics of risperidone and cardiovascular risk in children and adolescents. Int J Endocrinol 2016; 2016..
[http://dx.doi.org/10.1155/2016/5872423]
[31]
De Hert M, van Winkel R, Van Eyck D, et al. Prevalence of diabetes, metabolic syndrome and metabolic abnormalities in schizophrenia over the course of the illness: a cross-sectional study. Clin Pract Epidemiol Ment Health 2006a; 2: 14..
[http://dx.doi.org/10.1186/1745-0179-2-14] [PMID: 16803620]
[32]
Bobes J, Arango C, Aranda P, Carmena R, Garcia-Garcia M, Rejas J. Cardiovascular and metabolic risk in outpatients with schizophrenia treated with antipsychotics: results of the Clamors Study. Schizophr Res 2007; 99: 23-8.
[http://dx.doi.org/10.1016/j.schres.2006.09.025]
[33]
Rejas J, Bobes J, Arango C, Aranda P, Carmena R, Garcia-Garcia M. Concordance of standard and modified NCEP ATP III criteria for identification of metabolic syndrome in outpatients with schizophrenia treated with antipsychotics: a corollary from the CLAMORS study. Schizophr Res 2008; 99(1-3): 23-8.
[http://dx.doi.org/10.1016/j.schres.2007.10.015 ] [PMID: 18063343]
[34]
Chadda RK, Ramshankar P, Deb KS, Sood M. Metabolic syndrome in schizophrenia: Differences between antipsychotic-naïve and treated patients. J Pharmacol Pharmacother 2013; 4(3): 176-86.
[http://dx.doi.org/10.4103/0976-500X.114596 ] [PMID: 23960422]

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