Metabolic Syndrome Prevalence and Reduction in Inmates Prescribed Antipsychotic Medications

Reeves, Roy R.; Tamburello, Anthony; DeBilio, Lisa

doi:10.1177/1078345817700802

Cited by 6 publications

(5 citation statements)

References 42 publications

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“…We could not determine the prevalence of metabolic syndrome because some of the analyses were not available (such as the values of LDL, HDL and blood pressure, which were not included in routine monitoring), but still, it is evident that, possibly due to low doses prescribed, a more physically active lifestyle, or both, the prevalence of obesity, hyperglycemia and hypercholesterolemia was almost nonexistent. This is in accordance with the findings of Reeves et al (2017). However, in this study, we noted that there is a lack of metabolic monitoring in prison settings that, despite mostly normal values of metabolic parameters among inmates, should be implemented.…”

Section: Resultssupporting

confidence: 92%

“…The use of psychotropic medications in incarcerated persons is beneficial in terms of symptoms reduction, prevention of relapse, suicide and violent outbursts. However, the use of those drugs, antipsychotics in particular, is commonly accompanied with adverse effects, some of which may significantly affect the quality of life and even increase the risk of serious metabolic and cardiovascular complications and death (Divac et al , 2014; Muench and Hamer, 2010; Reeves et al , 2017). Clozapine, as the most effective antipsychotic for aggressive and violent behavior could be very useful in forensic population, but is avoided due to adverse effects and the need for regular white blood cells (WBC) count monitoring.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of antipsychotic drugs prescribing in incarcerated persons in a Serbian correctional facility

Čekerinac,

Starčević,

Basailović

et al. 2023

IJOPH

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Purpose Prison settings have limited resources, and it is of particular interest to analyze which antipsychotics are commonly prescribed in these conditions and to determine the prevalence of the adverse effects. Design/methodology/approach A cross-sectional, epidemiological survey was used to measure the prevalence of antipsychotic prescribing among adult prisoners in Sremska Mitrovica Prison in 2020. Findings The prevalence of antipsychotic use was 7.58%. The most commonly prescribed antipsychotic was clozapine (45.36%), but also olanzapine, haloperidol and risperidone were prescribed. The incidence of extrapyramidal adverse effects was nonexistent and the metabolic parameters did not differ between participants using metabolic syndrome–inducing antipsychotics and those who were prescribed metabolically inert medications. The prescribed doses were lower compared with the recommended. Research limitations/implications This research includes certain points that should be cautiously considered. First, the data were cross-sectional and the findings did not provide causal interpretations. Second, the data are from a single penitentiary institution, albeit the largest in the country; however, that may affect the generalizability of the findings. Third, because the included subjects were not hospitalized, some laboratory analyses were not available, according to the local regulations, and thus the prevalence of metabolic syndrome could not be precisely determined. Practical implications The prevalence of the antipsychotic use in prison environment is significantly higher than in general population. The most frequently prescribed antipsychotics are clozapine and olanzapine. The prevalence of adverse effects is rare, however, that is possibly due to low doses of the prescribed antipsychotics. The list of therapeutic options available to the incarcerated persons in this facility is also limited. The list of available antipsychotics does not include some atypical antipsychotics with more favorable safety and tolerability profile, such as aripiprazole or cariprazine. Long-acting antipsychotic injectables were also not available to these patients. Laboratory analyses are not regularly conducted and do not include some essential parameters such as lipid status or differential blood count. Low-dose antipsychotics for behavioral symptoms appears to be well tolerated under prison conditions where adherence is assured. It is effective during the prison stay but long-term effects, especially after release from prison, had not been studied. Social implications This paper advocates for better quality of health care in this correctional facility: more therapeutic options and better laboratory monitoring. The authors justify the use of clozapine in this settings due its benefits in reducing violence and aggression; however, further research would be necessary to clarify does the use of clozapine in incarcerated persons cause behavioral improvements that could result in shorter incarcerations, less recidivism and better quality of life. Originality/value To the best of the authors’ knowledge, this is the first insight of the antipsychotic prescribing practice in Serbia. There is very limited data on prisoners’ health care, especially mental health care, in Balkan countries. The antipsychotic prescribing pattern in this sample is characterized with higher than expected clozapine use, but without expected adverse effects.

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Section: Resultssupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Analysis of antipsychotic drugs prescribing in incarcerated persons in a Serbian correctional facility

Čekerinac,

Starčević,

Basailović

et al. 2023

IJOPH

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“…Por todas estas razones, se hace necesaria la implementación de sistemas de monitorización de todos los pacientes en tratamiento con antipsicóticos atípicos, ajustando bien la dosificación, evitando el uso de combinaciones múltiples de estos, controlando el peso, el índice de masa corporal, el perímetro abdominal, la presión arterial, los niveles de prolactina y realizando un electrocardiograma 26 . También se ha llevado a cabo este tipo de monitorización en pacientes penitenciarios, consiguiendo una disminución en la prevalencia del síndrome metabólico, así como una disminución en las prescripciones de neurolépticos con el transcurso del tiempo 27 .…”

Section: Discussionunclassified

“…For all these reasons, monitoring systems need to be implemented for all patients undergoing treatment with atypical antipsychotics, with adequate adjustments to dosage, avoiding the use of multiple combinations of antipsychotics, checking weight, BMI, abdominal circumference, blood pressure, prolactin levels and ECG tests 26 . This type of monitoring has been carried out on prison patients, and has brought about a decrease in the prevalence of metabolic syndrome, along with a drop in the number of prescriptions for neuroleptic drugs over time 27 .…”

Section: Discussionmentioning

confidence: 99%

Influence of the use of atypical antipsychotics in metabolic syndrome

Doménech-Matamoros¹

2020

Rev Esp Sanid Penit

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Describir la relación entre el uso de fármacos antipsicóticos y la aparición del síndrome metabólico. Objetivos secundarios: enumerar los principales efectos secundarios del tratamiento con antipsicóticos. Determinar si existe algún tratamiento farmacológico que pueda contribuir a contrarrestar el síndrome metabólico. Material y método: Se realizó una revisión bibliográfica narrativa en las siguientes bases de datos: PubMed; Cochrane; CINA-HL (Cumulative Index to Nursing and Allied Health); IBECS (Índice Bibliográfico Español); LILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud); HealthCare. Se eligió preferentemente todos aquellos ensayos clínicos, así como artículos de revisión sistemática o artículos de revisión y algún artículo que se consideró relevante por su contenido. El periodo de tiempo se limitó entre enero de 2014 y noviembre de 2019. El idioma fue: inglés y español. Se rechazaron los artículos repetidos y los que no tuvieron relación con los objetivos. Los criterios de búsqueda fueron: "antipsychotic AND metabolic syndrome"; "schizophrenia AND metabolic syndrome"; "bipolar disorder AND metabolic syndrome"; "metabolic syndrome AND suicide NOT disorder"; "metabolic syndrome AND prisons"; "metabolic syndrome AND prolactin". Resultados: Fueron seleccionados 24 artículos de 510 consultados. Se evidenció la relación entre antipsicóticos atípicos y el síndrome metabólico. Se destacan también otros efectos anticolinérgicos, antidopaminérgicos, síndromes extrapiramidales, síndrome neuroléptico maligno, hipotensión, arritmias, sedación, hipovitaminosis D, aumento de prolactina, disfunción sexual, alteraciones del sueño, etc. Se encontraron también asociaciones farmacológicas con otros fármacos. Discusión: Existe una relación entre la utilización de antipsicóticos atípicos y ganancia ponderal, alteraciones de lípidos, glucosa e hipertensión arterial. Hay fármacos que, asociados, disminuyen algunos síntomas (ranitidina, topiramato, metformina, melatonina, modafinilo). Es conveniente monitorizar el seguimiento de este tipo de pacientes y conseguir en ellos estilos de vida saludable.

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“…Concerning the monitoring of patients on AP, low levels of metabolic screening have also been shown in other populations, e.g., a recent random retrospective review of 100 charts from Australia showed that none of the patients on AP were monitored every 3 months as recommended, and such monitoring decreased over one year (Ward et al 2018). On the other hand, studies have shown that regular monitoring of patients maintained on SGA can significantly reduce the prevalence of MetS and the use of AP in general (Phillips et al 2015;Reeves et al 2017). Thus, closer clinical monitoring and administrative auditing are needed to improve the health outcomes of patients on AP in Qatar.…”

Section: Discussionmentioning

confidence: 99%

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

Hammoudeh

Lawati

Ghuloum

et al. 2019

Community Ment Health J

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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.

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Metabolic Syndrome Prevalence and Reduction in Inmates Prescribed Antipsychotic Medications

Cited by 6 publications

References 42 publications

Analysis of antipsychotic drugs prescribing in incarcerated persons in a Serbian correctional facility

Analysis of antipsychotic drugs prescribing in incarcerated persons in a Serbian correctional facility

Influence of the use of atypical antipsychotics in metabolic syndrome

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

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