Drug-emergent metabolic syndrome in patients with schizophrenia receiving atypical (second-generation) antipsychotics

BACKGROUND: Persons with schizophrenia are reported to be more likely to die from cardiovascular illness than those in the general population, and are at a greater risk of developing obesity, diabetes type 2, hypertension and dyslipidemias. Antipsychotic drugs used in the treatment of schizophrenia and other psychotic illnesses can induce weight gain, with some agents having a greater propensity to do so than others. These adverse effects associated with second-generation antipsychotics are also part of the metabolic syndrome. AIMS: The aim of this study was to evaluate the emergence of metabolic syndrome due to second-generation antipsychotics as compared with conventional (typical) antipsychotics. SETTINGS AND DESIGN: A prospective interventional study was conducted at the Psychiatric Centre, Jaipur. The study included 120 patients, both indoor and outdoor, suffering from schizophrenia diagnosed using the ICD-10 criteria. The patients were grouped into four categories, i.e. control group and three study groups, each group having 30 patients. MATERIALS AND METHODS: Thirty patients were given conventional antipsychotics and 90 were given second-generation antipsychotics, including risperidone, olanzapine and clozapine. Metabolic parameters were taken before onset of drug treatment therapy and after 4 months. The changes in metabolic parameters were compared using appropriate statistical tools. STATISTICAL ANALYSIS: Chi square chart and Unpaired t-test were used for statistical analysis using a computer. RESULTS: 11.66% of the patients developed metabolic syndrome after 4 months of antipsychotic medication. CONCLUSIONS: Second-generation antipsychotics cause significantly more changes in the metabolic parameters, increasing the chances of developing metabolic syndrome and associated disorders like diabetes mellitus type-II and cerebrovascular accidents. Olanzapine is the antipsychotic drug that has the maximum potential to cause metabolic syndrome.