Metabolic Changes in Patients Treated with Antipsychotics for Schizophrenia

Compared to control cases, there was significant elevation of metabolic parameters in patients treated for schizophrenia, and the type of drug used often mattered.

Investigators from Egypt examined patients with schizophrenia compared to healthy controls in order to evaluate the impact of antipsychotics on schizophrenic’s metabolic parameters after a period of 6 months. Between January 2010 and November 2012, the study authors involved 160 patients with schizophrenia and 50 healthy volunteers.

Among patients with schizophrenia, 59 were treated with haloperidol, 48 on clozapine, 45 on risperidone, and 38 on olanzapine. The investigators also noted the patients’ clinical evaluation, duration of illness, type of schizophrenia, detailed drug history, and BMI measures. Additionally, the patients underwent laboratory testing including fasting and post prandial blood glucose levels, total leucocytic count, liver function tests, and lipid profile at baseline and after 6 months.

The investigators determined that treatment with antipsychotics impacted fasting blood glucose levels, but was not significant in altering post prandial blood glucose measurements. They said this meant “that the factor of treatment with antipsychotic is not a contributing factor in the changes in post prandial blood glucose in such model of interaction.” They also noted that the type of drug was not significant in fasting blood glucose, but only weakly significant in post prandial blood glucose.

The lipid profile changes were not significant after 6 months, the investigators said. Changes in the lipid profile are due to other factors, and not the drugs.

Waist circumference and body weight changes were believed to stem from antipsychotic treatment, the study authors found. This was found across all medication types utilized, but patients treated with clozapine and olanzapine showed the most increase in both measures during the study period, while the risperidone-treated group showed the least changes.

For both serum glutamic oxalo-acetic transferase (SGOT) and serum glutamic-pyruvic transferase (SGPT), the study authors said that antipsychotic treatment in liver enzyme changes was significant. So was the type of drug used: the patients treated with olanzapine showed the highest changes, followed by clozapine, while patients treated with haloperidol and risperidone showed the lowest changes.

The type of drug used was also significant in terms of the liver enzyme changes, the study authors wrote. Patients that used haloperidol showed significant rise in the total leukocyte count, while risperidone and olanzapine showed no significant rise. The investigators said patients treated with clozapine showed no significant decrease in total leukocyte count.

These findings confirm that people with mental illness and schizophrenia in particular are at risk of high morbidity and mortality compared to the general population, the study authors wrote, and lifestyle, disease, and medications are the contributing factors for this risk.

“From the results of this study we can confirm the previous conclusions that metabolic disturbance in patients of schizophrenia is realty and worsens by time,” the study authors concluded. “Antipsychotics treatment may contribute in this effect particularly the novel ones but this effect could be a perpetuating or precipitating.”

The study, “Study of Biological Parameters of Schizophrenics During 6 Months of Different Anti Psychotics Treatment,” was published online in the Journal of Schizophrenia Research.