Background and aims. Patients with schizophrenia have a shorter life expectancy than normal population partially due to the metabolic side effects of antipsychotic treatment. The aim of this study is to evaluate the long-term evolution of the metabolic syndrome in chronic schizophrenia patients on fixed second generation antipsychotics (SGA). Material and method. The components of metabolic syndrome were evaluated repeatedly in a minimum 6 months and maximum 2 years follow-up period. The presence of metabolic syndrome (MetS) and metabolic risk scores (cMetS) according to National Cholesterol Education Program Adult Treatment Panel III were calculated and compared in time. In the prevalence, incidence and normalization logistic regression studies included all the known risk factors together with the follow-up period. Finally, all these rates were compared depending on the type of SGA. Results. Only cMetS, waist circumference and diastolic blood pressure presented significant increase in the follow-up period which was in average 385.5 days. The prevalence of MetS at base-line was 39.4%, which increased to 48.5% after the follow-up period. The calculated incidence of 30% was associated with a 23.1% rate of normalization. Logistic regression studies revealed as independent risk factors the age and base-line cMetS/weight for incidence and for normalization. In the aripiprazole group the normalization rate exceeded the incidence rate (33.3% vs 20%). Conclusions. The results emphasize the highly dynamic character of the metabolic syndrome even in chronic schizophrenia patients with fixed SGA regimen. The normalization of MetS is a possibility that should not ignored. The age and weight continue to remain independent risk factors, thus close monitoring in elderly and strict weight control plan are necessary. Aripiprazole showed better safety profile, but more extensive studies are required for definitive conclusions.

Background and aim: While the link between antipsychotic treatment and metabolic adverse events, including type 2 diabetes mellitus (T2DM) are clear in adults with schizophrenia, in young this association is not so well studied although the use of secondgeneration antipsychotics (SGA) is more and more frequent. Material and methods: The local diabetes register was compared with the list of all registered young adults (18-35 years) with schizophrenia 2 years retrospective and 2 years prospective. Cumulative incidence, rate of incidence and relative risk was calculated knowing the number of persons in this age group within this region. Results: Cumulative incidence for exposed group was 0.7% with a rate of incidence of 6.27 (95%CI: 4.1-10.5) per 1,000 patientyears, when in normal population was 0.2%, respectively 2.01 (95%CI: 0.72-3.79). This means a relative risk of 3.4736 (95%CI: 1.79-6.72), p=0.0002 and NNH=202 (95%CI: 134-404). Multivariate analysis showed that gender male (OR=1.83; 95%CI: 0.9-2.7; p=0.002) and olanzapine prescription (OR=4.76; 95%CI: 1.7-7.7; p=0.0001) were independent risk factors for T2DM. Conclusions: The metabolic risk should be taken in account every time introducing or changing a SGA in young schizophrenic patient, balancing the benefits and negative metabolic effects (especially with olanzapine). Healthy nutrition and physical activities are necessary components of these patients lifestyle to avoid early onset of T2DM.