Cerit Cem, Vural Meltem, Bos Gelmez S Ükriye, Ozten Eylem, Aker Ahmet Tamer, Yıldız Mustafa
Haydarpas¸a Numune Training and Research Hospital, Istanbul, Turkey.
Psychopharmacol Bull. 2010;43(4):22-36.
High prevalence of metabolic syndrome (MS) and related metabolic disturbances in patients with schizophrenia and bipolar affective disorder have been in main focus of interest in recent years since the introduction of second-generation antipsychotics. This study aims to examine these questions: 1) Is there a relation between antipsychotic treatment and MS prevalence? 2) Which antipsychotic users have higher MS prevalence? 3) Do patients on antipsychotic polytherapy have higher rates of MS than patients on antipsychotic monotherapy? 4) Which metabolic parameters are considerably disturbed on which antipsychotic users?
242 Patients with schizophrenia, schizoaffective disorder and bipolar disorder without any other psychiatric comorbidity according to DSM-IV and using the same antipsychotic(s) and/or mood stabilizers at least for the last 6 months included to the final assessment.
The sample was divided into 7 drug groups. The MS prevalence was highest in the combined antipsychotic (AA) group (48.1%) according to ATP III criteria. According to IDF criteria clozapine (C) group had the highest MS prevalence (74%).
When metabolic parameters evaluated overall, metabolic risk with antipsychotics is found to be highest in clozapine group, followed by combined AP group. Olanzapine and risperidone have intermediate risk while zuclopentixole has lowest.
自第二代抗精神病药物问世以来，精神分裂症和双相情感障碍患者中代谢综合征（MS）及相关代谢紊乱的高患病率一直是近年来主要关注的焦点。本研究旨在探讨以下问题：1）抗精神病药物治疗与MS患病率之间是否存在关联？2）哪些使用抗精神病药物的患者MS患病率更高？3）接受抗精神病药物联合治疗的患者MS发生率是否高于接受单一抗精神病药物治疗的患者？4）哪些抗精神病药物使用者的哪些代谢参数受到显著干扰？
根据《精神疾病诊断与统计手册》第四版（DSM-IV），纳入242例精神分裂症、分裂情感性障碍和双相情感障碍患者，这些患者无任何其他精神科合并症，且在至少过去6个月内使用相同的抗精神病药物和/或心境稳定剂，纳入最终评估。
样本分为7个药物组。根据ATP III标准，联合抗精神病药物（AA）组的MS患病率最高（48.1%）。根据国际糖尿病联盟（IDF）标准，氯氮平（C）组的MS患病率最高（74%）。
总体评估代谢参数时，发现抗精神病药物中氯氮平组的代谢风险最高，其次是联合抗精神病药物组。奥氮平和利培酮的风险中等，而珠氯噻醇的风险最低。
