Abstract
The second generation antipsychotic agents, although exhibit superior safety profile, is associated with metabolic adverse effects including weight gain, diabetes mellitus and hyperlipidaemia. These adverse effects are not only the risk factors for cardiovascular disease and diabetes mellitus but may also impair patient's adherence to treatment. However, different member of second generation antipsychotics differ. in their extent of metabolic adverse effects. The aim of the study was to evaluate the association between olanzapine, risperidone or quetiapine treatment and body mass index, blood pressure, diabetes mellitus and hyperlipidaemia in patients with Schizophrenia and Bipolar Disorder. Forty-four cases of Schizophrenia and Bipolar Disorder diagnosed with DSM-IV criteria were selected according to inclusion and exclusion criteria. Body weight, body mass index and blood pressure were measured at baseline, at the end of 4th, 8th and 12th weeks of treatment. Blood samples were collected to measure blood glucose and serum lipid profile at baseline and at the end of 4th, 8th and 12th weeks in the study group receiving treatment (olanzapine 20-30 mg/day, risperidone 4-16 mg/day and quetiapine 300-800 mg/day) after overnight fasting. Therapeutic use of olanzapine and risperidone in Schizophrenia and Bipolar Disorder for a period of 4th, 8th and 12th weeks was associated with significant increase in body weight and body mass index. Quetiapine did not cause significant changes in body weight and body mass index after 4 and 8 weeks. However, after 12 weeks treatment, body mass index increased significantly. Olanzapine, risperidone and quetiapine increased the blood glucose level significantly after 8 and 12 weeks treatment. Olanzapine and risperidone elevated the serum cholesterol, triglyceride and low density lipoprotein levels significantly after 4, 8 and 12 weeks. But quetiapine showed no significant change in lipid profile. However, olanzapine and risperidone significantly increased triglyceride level after 8 and 12 weeks. Amongst three drugs, quetiapine treatment increased high density lipoprotein level. Our study revealed that quetiapine treatment is associated with less risk of dyslipidaemia.
Highlights
Mental illness has reached to an alarming proportion over the globe and has become a vitally important issue for the nations in terms of morbidity, mortality and huge economic burden
In psychosis there is reduced central serotoninergic neurotransmission that results in increased food intake and weight gain and can contribute to increased storage of fat which leads to dyslipidaemia, hypertension, and increased risk for Type 2 Diabetes Mellitus and is, a key factor in the development of cardiovascular disease and associated mortality and morbidity.[5,6]
Framingham Heart study confirmed that in patients with obesity, diabetes, hypertension and dyslipidaemia, there is increased risk of cardiovascular disease and it has been suggested to occur at a higher frequency in patients with Schizophrenia than in the general population.[6,7]
Summary
Mental illness has reached to an alarming proportion over the globe and has become a vitally important issue for the nations in terms of morbidity, mortality and huge economic burden. Schizophrenia is the most common psychotic disorder. It affects 24 million people across the world[1]. Premature mortality, associated with major mental disorders, is primarily related to coronary heart disease. Such patients have a 2-3 fold increased risk of death, and this mortality gap associated with mental illness compared to the general population has widened in recent decades.[2,3]. In psychosis there is reduced central serotoninergic neurotransmission that results in increased food intake and weight gain and can contribute to increased storage of fat (in visceral adipose tissue) which leads to dyslipidaemia, hypertension, and increased risk for Type 2 Diabetes Mellitus and is, a key factor in the development of cardiovascular disease and associated mortality and morbidity.[5,6] Framingham Heart study confirmed that in patients with obesity, diabetes, hypertension and dyslipidaemia, there is increased risk of cardiovascular disease and it has been suggested to occur at a higher frequency in patients with Schizophrenia than in the general population (about 1.5 to 2 times greater).[6,7]
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