Risk Factors of Metabolic Syndrome Among Patients Receiving Antipsychotics: A Retrospective Study

Samer Hammoudeh,Yassin Eltorki,Hany Ghabrash,Iman Amro,Huma Iram,Mena Shehata,Hawra Al Lawati,Hira Safdar,Hassen Al-Amin,Suhaila Ghuloum,Nora Al-Fakhri,Arij Yehya,Imen Becetti,Nighat Ajmal

doi:10.1007/s10597-019-00537-y

Abstract

This study aimed to assess the differential effects of first-generation (FGA) and second-generation antipsychotics (SGA) on the prevalence of risk factors for metabolic syndrome among mentally ill patients in Qatar. We also wanted to check if there is proper adherence with the guidelines for prescribing antipsychotics and the monitoring of metabolic effects in this population. We collected the available retrospective data (socio-demographic, psychiatric, anthropometric, and metabolic measures) from the records of 439 patients maintained on antipsychotics. The majority were males, married, employed, having a psychotic disorder, and receiving SGA. Patients on SGA showed more obesity, higher BP, and more elevated triglycerides compared to those on FGA. The prevalence of the abnormal metabolic measures was high in this sample, but those on SGA showed a significantly higher prevalence of abnormal body mass index and BP. Obesity and hypertension were common in patients maintained on antipsychotics, especially those on SGA. Polypharmacy was common, and many metabolic measures were not monitored properly in those maintained on antipsychotics. More prospective studies with guided monitoring of the patients' clinical status and metabolic changes are needed to serve better this population of patients.

Highlights

Psychosis is a common mental condition that might alter the reality testing of the affected individuals (Kay and Tasman 2006)
Clozapine and olanzapine were associated with a substantial increase in weight when compared to other second-generation antipsychotics (SGA), while chlorpromazine was the worst culprit amongst the first-generation antipsychotics (FGA) (De Hert et al 2011)
In the FGA group, the majority was on haloperidol (n = 42) followed by trifluoperazine (n = 11), chlorpromazine (n = 9), fluphenazine (n = 2), and zuclopenthixol (n = 2)

Summary

Introduction

Psychosis is a common mental condition that might alter the reality testing of the affected individuals (Kay and Tasman 2006). Community Mental Health Journal (2020) 56:760–770 is still not clear how much the psychosis itself or the use of AP contributes to these metabolic effects. Other population studies reported that there were no differences in the prevalence of MetS between patients with chronic mental illness and controls (Baptista et al 2011; Suzuki et al 2013; Saloojee et al 2016). Few studies from other countries like the one from Venezuela (Baptista et al 2011) reported that there were no differences in MetS when comparing patients on AP and the general population

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Discussion

Conclusion