Typical and atypical antipsychotics differentially affect long-term incidence rates of the metabolic syndrome in first-episode patients with schizophrenia: A retrospective chart review

Hert, Marc De; Schreurs, Vincent; Sweers, Kim; Eyck, Dominique Van; Hanssens, Linda; Šinko, Sebastjan; Wampers, Martien; Scheen, André; Peuskens, Joseph; Winkel, Ruud van

doi:10.1016/j.schres.2008.01.028

Cited by 223 publications

(140 citation statements)

References 63 publications

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“…Metabolic syndrome has been recognized as a risk factor in patients with severe mental illnesses like schizophrenia. 25 However, De Hert et al 26 reported prevalence of metabolic syndrome to be three times more in second-generation antipsychotic treated group than in the first-generation treated patients contrary to our findings. Majority of atypical antipsychotics have been associated with weight gain.…”

Section: 13contrasting

confidence: 99%

Long-term Effectiveness and Tolerability Profile of Iloperidone in Patients of Psychosis

Kuchhal¹,

Singh²,

Singh³

et al. 2017

International Journal of Advanced and Integrated Medical Sciences

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Aim:To evaluate the long-term efficacy, tolerability, and safety profile of iloperidone. Materials and methods:A 12 month, prospective, interventional, open label, flexible dose study was conducted on 50 drug naïve, first-episode patients aged 18 to 65 years, fulfilling the International Classification of Diseases-10 criteria for psychosis, for assessing long-term efficacy and adverse events, including biochemical parameters of iloperidone. Detailed clinical examination was carried out. Sociodemographic data and baseline parameters were recorded.Results: Two patients dropped out during the course of therapy. M/F ratio was 1.77:1. Mean age of patients was 28.76 ± 10.28 [mean ± standard deviation (SD)] years. Rural/urban ratio was 2.84:1.25. Patients were illiterate, 18 belonged to low socioeconomic class. It was observed that iloperidone was fairly efficacious not only in preventing relapse or aggravation of symptoms but also well restored the patient to almost near-normal till the end point. After 3 months, 20/48 (41.66%) patients showed significant weight gain that was evident. Mean total weight gain from baseline to end point was 2.89 kg and was statistically significant. There was significant rise in body mass index (BMI) but no patient crossed the upper normal limit. Iloperidone did not cause significant rise (p < 0.6955) in fasting blood sugar (FBS), and no significant alterations in total cholesterol (TC), triglyceride, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol were recorded. Dizziness was one of the earliest adverse events appearing within 2 to 3 days; others were insomnia, weight gain, increased appetite, anxiety, headache, sedation, etc. Conclusion:On long-term basis, iloperidone is fairly efficacious and has favorable tolerability profile with modest weight gain and practically no alteration in FBS, and lipid profile as well as absence of extrapyramidal side effects.

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Section: 13contrasting

confidence: 99%

Long-term Effectiveness and Tolerability Profile of Iloperidone in Patients of Psychosis

Kuchhal¹,

Singh²,

Singh³

et al. 2017

International Journal of Advanced and Integrated Medical Sciences

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“…3 In a study of MetS in first-episode patients with schizophrenia treated with typical or AAPs, it was found that, at first episode, there was no difference in the prevalence of MetS between the historical and the current cohort. 4 However, rates of MetS increased over time in both groups, but patients treated with AAPs had a three times higher incidence rate of MetS (odds ratio 3.6). In another study of 3-month follow-up of female patients with schizophrenia treated with AAPs, it was found, at baseline, 15% fulfilled criteria for MetS, and, after 3 months of treatment, 27% fulfilled criteria for MetS.…”

Section: Introductionmentioning

confidence: 87%

Gene–gene interactions of the INSIG1 and INSIG2 in metabolic syndrome in schizophrenic patients treated with atypical antipsychotics

Lin

et al. 2010

Pharmacogenomics J

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The use of atypical antipsychotics (AAPs) is associated with increasing the risk of the metabolic syndrome (MetS), which is an important risk factor for cardiovascular disease and diabetes. Two insulin-induced gene (INSIG) isoforms, designated INSIG-1 and INSIG-2 encode two proteins that mediate feedback control of lipid metabolism. In this genetic case-control study, we investigated whether the common variants in INSIG1 and INSIG2 genes were associated with MetS in schizophrenic patients treated with atypical antipsychctics. The study included 456 schizophrenia patients treated with clozapine (n ¼ 171), olanzapine (n ¼ 91) and risperidone (n ¼ 194), for an average of 45.5±27.6 months. The prevalence of MetS among all subjects was 22.8% (104/456). Two single-nucleotide polymorphisms (SNPs) of the INSIG1 gene and seven SNPs of the INSIG2 gene were chosen as haplotypetagging SNPs. In single-marker-based analysis, the INSIG2 rs11123469-C homozygous genotype was found to be more frequent in the patients with MetS than those without MetS (P ¼ 0.001). In addition, haplotype analysis showed that the C-C-C haplotype of rs11123469-rs10185316-rs1559509 of the INSIG2 gene significantly increased the risk of MetS (P ¼ 0.0023). No significant associations were found between polymorphisms of INSIG1 gene and MetS, however, INSIG1 and INSIG2 interactions were found in the significant 3-locus and 4-locus gene-gene interaction models (P ¼ 0.003 and 0.012, respectively). The results suggest that the INSIG2 gene may be associated with MetS in patients treated with AAPs independently or in an interactive manner with INSIG1.

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“…Hypotheses on the association between schizophrenia and diabetes (adapted from Leucht et al [2007aLeucht et al [ , 2007b of the study group varied, however male patients appeared to be over represented. In most studies the mean age of participants in the study group was over 40 years of age, and only a few studies referred to patients with first episode schizophrenia [Attux et al 2007;Saddichha et al 2007;De Hert et al 2008b;Saddichha et al 2008;Curtis et al 2011]. The predominant diagnosis of patients studied was schizophrenia, however a great number of studies also included patients with schizoaffective disorder and other psychotic disorders.…”

Section: Study Selectionmentioning

confidence: 99%

The prevalence and mechanisms of metabolic syndrome in schizophrenia: a review

Papanastasiou¹

2012

Therapeutic Advances in Psychopharmacology

103

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Metabolic syndrome: introduction The metabolic syndrome (MetS, also known as syndrome X, syndrome of chronic cardiovascular disease and Reaven's syndrome) is a constellation of different conditions, including abdominal obesity, insulin resistance, dyslipidaemia and elevated blood pressure. All components of the MetS (with obesity holding a central role in its development) have been recognized as independent risk factors for cardiovascular disease and so the presence of MetS is associated with other comorbidities such as the prothrombotic state, proinflammatory state, nonalcoholic fatty liver disease and reproductive disorders [Cornier et al. 2008]. Owing to its multiple components, many definitions have

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Typical and atypical antipsychotics differentially affect long-term incidence rates of the metabolic syndrome in first-episode patients with schizophrenia: A retrospective chart review

Cited by 223 publications

References 63 publications

Long-term Effectiveness and Tolerability Profile of Iloperidone in Patients of Psychosis

Long-term Effectiveness and Tolerability Profile of Iloperidone in Patients of Psychosis

Gene–gene interactions of the INSIG1 and INSIG2 in metabolic syndrome in schizophrenic patients treated with atypical antipsychotics

The prevalence and mechanisms of metabolic syndrome in schizophrenia: a review

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