Metabolic syndrome in antipsychotic naïve patients with schizophrenia: pooled analysis of data from three Indian studies.

AIM: This study aimed to assess the prevalence of metabolic syndrome (MS) and subthreshold MS in antipsychotic naïve patients with schizophrenia by pooling the data from three different centres in India. METHODS: One hundred thirty-seven antipsychotic naïve patients with schizophrenia were evaluated for MS using common criteria for clinical diagnosis. RESULTS: Twenty-six patients (19%) met consensus criteria. Additionally, 56 patients (40.9%) fulfilled one criterion and 32 patients (23.3%) fulfilled two criteria of MS out of five criteria. CONCLUSION: One-fifth of antipsychotic naïve patients with schizophrenia had MS and another two-third had at least one metabolic abnormality. Awareness of such a high risk is vitally important for rational selection of antipsychotic medications as well as effective implementation of preventive measures.

Metabolic syndrome in schizophrenia: a comparative study of antipsychotic-free/naïve and antipsychotic-treated patients from India.

INTRODUCTION: In recent years, metabolic syndrome (MS) has been identified as an important health risk in patients with schizophrenia and related disorders, and has often been related to the use of second-generation antipsychotics. OBJECTIVE: The present study was conducted to assess the prevalence of MS in schizophrenia and related disorders and its correlation with various demographic, clinical and treatment variables. METHOD: One hundred patients with schizophrenia and related disorders, 50 antipsychotic-free/naïve and 50 on antipsychotic medications for more than 3 months, attending a psychiatric outpatient setting, were assessed for various socio-demographic, clinical and metabolic parameters. RESULTS: Subjects on treatment with antipsychotics had significantly higher mean weight, body mass index, waist circumference, calorie intake, triglycerides (TGL), very-low-density lipoproteins (VLDL), fasting blood sugar (FBS) and positive family history of diabetes mellitus compared with the antipsychotic-free/naive ones. Subjects on antipsychotics also had significantly higher prevalence of MS. A positive association of MS was observed with age, being married, higher education, executive jobs and ICD-10 diagnosis of schizophrenia, duration of illness, family history of diabetes mellitus and family history of hypertension. CONCLUSION: Use of antipsychotics increases the risk of developing hyperlipidemia and MS in patients of schizophrenia and related disorders, emphasizing the need for regular monitoring of various metabolic parameters in patients on antipsychotics. CLINICAL IMPLICATIONS: 1) Antipsychotics are associated with increased risk of hyperlipidemia and MS; 2) regular monitoring of lipid profile and other metabolic parameters should be done in patients on antipsychotics; 3) psychiatrists need to lay emphasis on lifestyle and dietary modifications in their patients on antipsychotics.