Metabolic syndrome in psychiatrically hospitalized patients treated with antipsychotics and other psychotropics

Centorrino, Franca; Masters, Grace A.; Talamo, Alessandra; Baldessarini, Ross J.; Öngür, Döst

doi:10.1002/hup.2257

Cited by 46 publications

(37 citation statements)

References 30 publications

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“…The study was reviewed and approved for anonymous and aggregate reporting of findings by the hospital's Institutional Review Board. Other findings arising from the present cohort have been reported previously [24,54,55].…”

Section: Methods Subjects and Data Acquisitionsupporting

confidence: 90%

Factors Associated with Costs of Hospitalization of Severely Mentally Ill Patients

Curto¹,

Masters²,

Girardi³

et al. 2016

Bipolar Disord

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Section: Methods Subjects and Data Acquisitionsupporting

confidence: 90%

Factors Associated with Costs of Hospitalization of Severely Mentally Ill Patients

Curto¹,

Masters²,

Girardi³

et al. 2016

Bipolar Disord

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“…Dvije novije studije provedene među pacijentima sa shizofrenijom u hrvatskoj populaciji ukazuju na visoku učestalost metaboličkog sindroma koja je varirala od 15 do 57 % 21,22 . Osim toga, nekoliko istraživanja koja su uključila kronične pacijente sa shizofrenijom u hrvatskoj populaciji ukazuje da gotovo 100 % oboljelih uzima atipične antipsihotike, posebice klozapin i olanzapin, koji se povezuju s najvećim rizikom za metaboličke abnormalnosti 21,[23][24][25] , kao i da visok postotak pacijenata puši (muškarci: 69 -71 %; žene: 46 -61 %) 26,27 . U ovom preglednom radu iznesene su najnovije spoznaje o ulozi okolišnih i genetičkih čimbenika u etiopatogenezi metaboličkog sindroma u shizofreniji; s obzirom na to da su dosadašnja istraživanja prvenstveno bila usredotočena na moguću poveznicu antipsihotičnih lijekova i metaboličkih abnormalnosti u oboljelih, detaljnije su, u skladu s postojećim literaturnim podacima, razmotrene značajke nezdrave prehrane i ovisnosti o pušenju te njihova moguća povezanost s metaboličkim sindromom.…”

Section: Uvodunclassified

“…53, No. 1, p. 27-42 boličkog sindroma; porast tjelesne mase, uz razvoj hipertrigliceridemije i inzulinske rezistencije smatraju se najučestalijim manifestacijama metaboličkog sindroma koje se vezuju uz upotrebu navedenih lijekova 23,37 . Čini se da blokada serotoninskih 5-HT2 receptora i histaminskih H1 receptora antipsihotičnim lijekovima najviše pridonosi porastu tjelesne mase u pacijenata sa shizofrenijom; istraživanja na animalnim modelima i u humanoj populaciji pokazala su da inhibicija navedenih neurotransmiterskih sustava, osim što opušta (sedira) pacijenta i tako smanjuje fizičku aktivnost, ima za posljedicu smanjenje učinka "hormona sitosti" -leptina na kontrolu unosa hrane u hipotalamusu, što rezultira pojačanom sekrecijom leptina, razvojem rezistencije na leptin i povećanim apetitom 24,38,39 .…”

Section: Povezanost Terapije Antipsihotičnim Lijekovima S Metaboličkiunclassified

Etiopathogenesis of metabolic syndrome in schizophrenia – recent findings

et al. 2017

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Sažetak. Uzrok polovice do dvije trećine smrtnih ishoda pacijenata sa shizofrenijom pripisuje se kardiovaskularnim bolestima. Smatra se da visoka učestalost metaboličkog sindroma najviše povećava rizik za nastanak kardiovaskularnih oboljenja u shizofreniji. Iako je metabolički sindrom jedan od vodećih uzroka morbiditeta i mortaliteta u pacijenata sa shizofrenijom, do prije petnaestak godina istraživanje etiologije metaboličkog sindroma u shizofreniji nije predstavljalo veći znanstveni interes. Novije spoznaje ukazuju na mogućnost da bi pojačano stanje upalnog odgovora u organizmu moglo predstavljati zajedničku etiopatogenetsku podlogu u nastanku metaboličkog sindroma i shizofrenije. Primjerice, značajno povišena koncentracija proupalnih citokina te C reaktivnog proteina uočena je u pacijenata sa shizofrenijom koji nisu uzimali antipsihotične lijekove ili su ih uzimali u vrlo malim dozama, a zamijećeno je i da uzimanje inhibitora ciklooksigeneze-2, uz antipsihotičnu terapiju, može ublažiti težinu kliničkih simptoma i kognitivnih deficita u oboljelih. U ovom preglednom radu iznesene su najnovije spoznaje o ulozi okolišnih i genetičkih čimbenika u etiopatogenezi metaboličkog sindroma u shizofreniji. Mnogi mehanizmi kojima bi okolišni čimbenici, poput nezdrave prehrane i pušenja, mogli pridonijeti nastanku metaboličkog sindroma u shizofreniji ne razlikuju se značajno u odnosu na opću populaciju. Ipak, uzimanje antipsihotičnih lijekova, posebice tzv. atipičnih antipsihotika, te njihova interakcija s okolišnim čimbenicima, kao i genetičkim čimbenicima podložnosti, dodatno pridonose heterogenosti etiopatogeneze metaboličkog sindroma u shizofreniji, ali i otežavaju adekvatan terapijski pristup. Budući da su dosadašnja istraživanja uglavnom bila usredotočena na moguću poveznicu antipsihotičnih lijekova i metaboličkih abnormalnosti u oboljelih, detaljnije su razmotrene značajke nezdrave prehrane i ovisnosti o pušenju te njihova moguća povezanost s metaboličkim sindromom.Ključne riječi: antipsihotični lijekovi; genetika; prehrana; pušenje; shizofrenija Abstract. The etiology of one half to two-thirds of deaths among patients with schizophrenia could be attributed to cardiovascular diseases. It is believed that high prevalence of metabolic syndrome mostly contributes to the risk of cardiovascular diseases in schizophrenia. Although the metabolic syndrome is among the leading causes of morbidity and mortality among patients with schizophrenia, fifteen years ago studies investigating the etiology of the metabolic syndrome among patients with schizophrenia were not a part of scientific interest. Recent findings indicate the possibility that increased state of inflammatory response in the organism may underlie the etiopathogenesis of both schizophrenia and metabolic syndrome. For instance, significantly increased levels of proinflammatory cytokines and C reactive protein have been observed in schizophrenia patients with minimal or no exposure to antipsychotics and it has also been revealed that cyclooxygenase-2 inhibitor drugs ...

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“…Therefore, vulnerability factors for development of schizophrenia, diabetes, and MetS seem to be shared and interconnected. In patients with schizophrenia the risk is further greatly increased by the use of antipsychotic medication as reviewed repeatedly elsewhere 8,[51][52][53][54][55] . More specifically, elevated blood levels of adiponectin have been reported in schizophrenia 56 and there is a correlation between serum leptin levels and body weight 51 .…”

Section: Psychiatric Disorders and Metabolic Syndromementioning

confidence: 99%

The common pathophysiology underlying the metabolic syndrome, schizophrenia and depression. A review

Kučerová

Babinská

Horská

et al. 2015

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Background. There is a growing interest in metabolic alterations in patients with psychiatric disorders due to their increased risk for metabolic syndrome (MetS) development. Inflammation is known to underlie the pathophysiology of schizophrenia and depression as well as MetS. Vulnerability factors for schizophrenia/depression and MetS hence appear to be shared. Methods and Results. Based on a Web of Science search, this review examines current evidence for MetS pathophysiology involving dysregulation of adipose tissue signaling -adipokines and pro-inflammatory cytokine, both also known to be aberrant in schizophrenia/depression. Further, gender differences in the incidence and course of schizophrenia/ depression were reported. The disturbances linked to the MetS are also described. Therefore, this review further maps the gender differences in the psychiatric-metabolic comorbidities. Conclusion. There is evidence supporting a pathological predisposition to MetS in both schizophrenia and depression in both humans and animal models. This predisposition is dramatically enhanced by antipsychotic medication. Further, there are gender differences from clinical findings suggesting women with schizophrenia/depression are more vulnerable to MetS development. This has not yet been assessed in animal studies. We suggest further validation of existing schizophrenia and depression animal models for the assessment of metabolic disturbances to provide tools for developing new antipsychotics and antidepressants with "metabolically inert" profile or improving the metabolic status in schizophrenic/depressed patients.

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Metabolic syndrome in psychiatrically hospitalized patients treated with antipsychotics and other psychotropics

Cited by 46 publications

References 30 publications

Factors Associated with Costs of Hospitalization of Severely Mentally Ill Patients

Factors Associated with Costs of Hospitalization of Severely Mentally Ill Patients

Etiopathogenesis of metabolic syndrome in schizophrenia – recent findings

The common pathophysiology underlying the metabolic syndrome, schizophrenia and depression. A review

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