Metabolic risk in selected second-generation antipsychotics.

BACKGROUND: Many studies have reported higher incidence of metabolic abnormalities in patients receiving antipsychotic medications than in general population. OBJECTIVES: The objective of our study was to determine the prevalence of metabolic syndrome in a group of patients receiving long-lasting antipsychotic treatment and also whether the cardiovascular risk among different second-generation antipsychotics varies. METHODS: Our study group consisted of 71 patients who were on antipsychotic monotherapy for at least 12 months. In each patient, fasting plasma glucose, HDL cholesterol, triglycerides, liver enzymes, bilirubin and plasma immunoreactive insulin levels were examined. We measured body weight, height, body mass index, waist circumference and body fat percentage together with blood pressure and heart rate. We assessed metabolic syndrome prevalence in the study group and correlations among its components as well as between them and other variables. The data were processed by statistics programme STATISTICA 8.0. For detection of correlations Spearman's rank correlation test was used. RESULTS: The prevalence of metabolic syndrome in our sample reached 41%. The highest prevalence rate of 50% was detected in the olanzapine subgroup. Identical prevalence of 40% was observed in quetiapine and risperidone subgroups. The lowest prevalence of 25% and 31% was observed in sertindol and amisulpirid subgroup, respectively. The prevalence rate of metabolic syndrome in men was 51% compared to 34% in women. CONCLUSION: According to metabolic syndrome prevalence rates olanzapine appears to be associated with the highest cardiovascular risk, amisulpirid and sertindol appear to be much safer (Tab. 2, Ref. 13).

Respiratory sinus arrhythmia is reduced in adolescent major depressive disorder.

OBJECTIVE: Although the emotion regulatory difficulties in patients with major depressive disorder (MDD) are predicted to associate with impaired cardiovascular autonomic regulation, the changes of cardiac vagal regulation MDD are incompletely understood. The aim of the study was to evaluate the respiratory sinus arrhythmia (as an index of cardiac vagal regulation) using the spectral analysis in high frequency band of the heart rate variability and the indices of deep breathing test in adolescent patients with major depressive disorder. MATERIAL AND METHOD: Twenty-eight adolescent girls were examined - 14 patients with major depressive disorder without pharmacological treatment (average age: 16.4 +/- 0.2 yr) and 14 healthy probands (control group) matched for age and gender. The respiratory sinus arrhythmia was evaluated using the spectral analysis in high frequency band of the heart rate variability (HF-HRV) and the parameters of deep breathing test (I-E, I/E). In addition, mean R-R interval was calculated. RESULTS: The adolescent patients with MDD has significantly reduced spectral activity in the HF-HRV and lower I/E, I-E parameters compared to marched health subjects (P<0.05). CONCLUSIONS: We conclude that the adolescents girls with MDD have reduced respiratory sinus arrhythmia indicating cardiac vagal dysregulation. Since impaired cardiac vagal regulation is associated with increased risk of cardiovascular morbidity, this finding underscores the importance of impaired autonomic neuro-cardiac integrity already in adolescents with major depressive disorder without pharmacological treatment.