Letter to the Editor: Lipid profile disturbances in antipsychotic-naive patients with first-episode non-affective psychosis

Abstract

A note on versions:The version presented here may differ from the published version or, version of record, if you wish to cite this item you are advised to consult the publisher's version. Please see the 'permanent WRAP URL' above for details on accessing the published version and note that access may require a subscription. The study by Błażej Misiak and colleagues (Misiak et al., 2017) provides evidence that antipsychoticnaïve patients with first-episode non-affective psychosis may present with subclinical dyslipidaemia, namely a significantly lower total cholesterol, LDL cholesterol, HDL cholesterol, and higher triglycerides, compared with healthy controls. The authors completed sensitivity analyses to view the effect of confounders they named as age, sex, BMI and smoking status.The findings however are interesting and partly mirror our own meta-analysis (Perry et al., 2016), when we found significantly decreased HDL and total cholesterol in patients with first-episode psychosis compared with healthy matched controls. The sensitivity analysis in the study by Misiak and colleagues (Misiak et al., 2017) rendered LDL cholesterol non-significant, which also mirrors our findings.Our work primarily aimed to view the association between first-episode psychosis and subclinical dysglycaemia, as we hypothesized that intrinsic disease links, possibly with an inflammatory basis, may

Associations of antidepressants and antipsychotics with lipid parameters: Do CYP2C19/CYP2D6 genes play a role? A UK population-based study

“…We did not adjust for weak inhibitors as they have a much less clinically relevant impact on phenoconversion ( Center for Drug Evaluation and Research, 2021 ) and are therefore not typically included when accounting for inhibitors ( Cicali et al, 2021 ). We did not adjust for BMI in order to avoid the risk of overadjustment bias ( Perry and Singh, 2018 ).…”

Associations of antidepressants and antipsychotics with lipid parameters: Do CYP2D6/CYP2C19 genes play a role? A UK population-based study

“…35 We did not adjust for BMI in order to avoid the risk of overadjustment bias. 36 Effect estimates are reported with 95% confidence intervals (CIs) and uncorrected p values in tables and forest plots. Given analysis of three independent (LDL-C, HDL-C and triglycerides), and two highly correlated/combinatory (total cholesterol and TC:HDL ratio (the latter not included in pharmacogenetic analyses)), outcomes, we corrected for multiple testing by using an adjusted significance threshold of <0•013 (i.e., 0•05/4).…”