The Effect of Long-Term Second-Generation Antipsychotics Use on the Metabolic Syndrome Parameters in Jordanian Population

Abstract

Objectives: The aim of this study was to determine the incidence of metabolic syndrome in patients treated with second-generation antipsychotics (SGAs). Methods: In this retrospective study, we reviewed patients’ electronic medical records (EMRs) of all patients who received one SGA for at least six months, excluding patients who were taking other medications that are associated with significant effect on metabolic syndrome. Relevant clinical information was collected prior to starting the SGA and after six months of continuous use of the same SGA. Results: A total of 91 patients were included in the study. The majority of patients (72%) were diagnosed with schizophrenia. After six months of taking the SGA, 44% of patients experienced elevated systolic pressure, 54.9% had elevated triglyceride, and 31.9% had impaired glucose levels (p value < 0.05). Prior to initiating SGA therapy, 14.3% of patients had metabolic syndrome, while 37.4% had metabolic syndrome after six months of therapy, and it was more prominent in males compared to female patients (p value < 0.05). Conclusion: This study found a strong correlation between SGA use and the appearance of metabolic alterations, such as weight gain, glucose intolerance, and increased triglyceride levels. These findings highlight the importance of assessing metabolic deregulations to minimize SGA associated metabolic abnormalities.

Patterns and predictors of oral antipsychotic prescribing in adult patients with schizophrenia

“… 26 As such, SGAs may be avoided more in this population due to increased fall risk and/or worsening metabolic disorders. 29 , 30 , 31 , 32 , 33 This corresponds with the finding that patients with a higher number of chronic conditions also had a lower likelihood of being prescribed an SGA or FGA versus no antipsychotic. While ongoing pharmacologic treatment may help patients with schizophrenia achieve long-term remission and functional recovery, 34 there may come a time when the prescriber determines the risk of adverse effects associated with ongoing SGA use exceeds the potential benefit.…”

Perspectives of patients and healthcare professionals on metabolic monitoring of adult prescribed second-generation antipsychotics for severe mental illness: A meta-synthesis

“…Second-generation antipsychotics (SGAs) are preferred over first-generation antipsychotics due to the lower incidence of extrapyramidal side effects. However, SGAs are also associated with adverse effects such as weight gain and glucose intolerance, which can progress into metabolic syndrome, a cluster of disorders comprising hypertension, insulin resistance, obesity, and dyslipidaemia [ 1 ]. Metabolic syndrome comprises at least three out of five metabolic risk factors: abdominal obesity, elevated blood pressure, fasting glucose, triglycerides, or decreased high-density lipoproteins [ 1 ].…”

“…However, SGAs are also associated with adverse effects such as weight gain and glucose intolerance, which can progress into metabolic syndrome, a cluster of disorders comprising hypertension, insulin resistance, obesity, and dyslipidaemia [ 1 ]. Metabolic syndrome comprises at least three out of five metabolic risk factors: abdominal obesity, elevated blood pressure, fasting glucose, triglycerides, or decreased high-density lipoproteins [ 1 ]. Several SGAs are known to cause metabolic syndrome including olanzapine, risperidone, and clozapine [ 2 ].…”

“…Multiple factors including lack of awareness/ education about the relation between physical and mental health, lack of attention of healthcare professionals towards patients’ physical health, and patient affordability contribute to poor frequency [ 5 ]. To reduce iatrogenic morbidity and to improve the physical health monitoring of patients on SGAs, several guidelines recommend best practices but are seldom implemented in practice [ 1 ].…”

Associations of the SREBF2 Gene and INSIG2 Polymorphisms with Obesity and Dyslipidemia in Thai Psychotic Disorder Patients Treated with Risperidone

“…Risperidone is a commonly prescribed atypical antipsychotic (AAP) drug used for the treatment of schizophrenia and other psychotic disorders. Recently, there has been concern regarding many atypical antipsychotic drugs because of their propensity to induce metabolic disturbances such as type 2 diabetes, weight gain, dyslipidemia, and metabolic syndrome [1][2][3], which increase the risk of cardiovascular diseases [4,5]. Moreover, patients with psychotic disorders have two times the risk of cardiovascular disease (CVD) mortality as compared with people in the general population [6,7].…”