Biochemical Assessment of Cardiovascular Risk Associated with the Duration of Antipsychotic Therapy in Patients with Schizophrenia

Abstract

Background and objectives: Schizophrenia accounts for 78% of cases managed in Behavioural Sciences in Nigeria, and treatments with antipsychotic drugs may contribute to the onset of coronary heart disease (CHD) due to dyslipidaemia - associated complications. The prevention of CHD is preferable and less expensive than its management; thus, early identification and treatment may offer the possibility of reducing the devastating sequel. The aim of this study was to investigate the pattern of dyslipidaemia and cardiovascular risk (CVR) associated with duration of antipsychotic therapy inorder to improve awareness on early diagnosis, treatment and CVR reduction.
 Methods: This was a longitudinal (prospective) study involving 44 participants recruited through systematic random sampling. Each participant served as their own control. Four blood samples were obtained from each participant, starting with a baseline before the onset of antipsychotic therapy and subsequently at monthly intervals for three consecutive months from commencement of therapy. Parameters of routine and advanced lipid profiles were assayed and the atherogenic indices were calculated.
 Results: Both the routine and advanced lipid profiles werewithin reference limits at baseline. A significant increase in monthly levels was observed with dyslipidaemia noticed by the second month of antipsychotic therapy. There was an association established between the duration of therapy and a high CVR. The TC/HDL-C ratio performed better than apo B-100 and individual routine lipid profile fractions in the evaluation of CVR.
 Conclusions: Dyslipidaemia associated with high CVR may develop with antipsychotic therapy. Calculation of atherogenic indices was a good indicator of CVR.
 Keywords: Antipsychotics; Cardiovascular risk; Dyslipidaemia; Schizophrenia.