Smith Emily Chen Chen, Au Emily, Pereira Sandra, Sharma Eesha, Venkatasubramanian Ganesan, Remington Gary, Agarwal Sri Mahavir, Hahn Margaret
Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), 1051 Queen St. W, Toronto, ON M6J 1H3, Canada; Institute of Medical Sciences, University of Toronto, 1 King's College Circle, Medical Sciences Building, Room 2374, Toronto, ON M5S 1A8, Canada.
Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), 1051 Queen St. W, Toronto, ON M6J 1H3, Canada; Department of Pharmacology, University of Toronto, 1 King's College Circle, Medical Sciences Building, Room 4207, Toronto, ON, Canada.
Psychiatry Res. 2023 Oct;328:115472. doi: 10.1016/j.psychres.2023.115472. Epub 2023 Sep 7.
Antipsychotics (APs) are the cornerstone of treatment for schizophrenia (SCZ) spectrum disorders. Previous research suggests that there may be a positive association between AP-induced weight gain and/or dyslipidemia and improvement in psychiatric symptoms, often referred to as a "metabolic threshold". To determine whether a similar relationship exists for glucose parameters, we conducted a systematic search in six databases from inception to June 2022 for all longitudinal studies that directly examined the relationship between changes in glucose-related outcomes and changes in psychopathology among patients with SCZ treated with APs. We identified 10 relevant studies and one additional study that considered cognition. In most cases, we found that increased levels of fasting glucose and insulin following treatment were associated with clinical improvement. These findings contribute to existing literature that could suggest a common mechanism between AP action and metabolic side effects and support a need for additional work aimed at exploring the validity of a glucose-psychopathology relation in SCZ.
抗精神病药物（APs）是治疗精神分裂症（SCZ）谱系障碍的基石。先前的研究表明，APs引起的体重增加和/或血脂异常与精神症状改善之间可能存在正相关，这通常被称为“代谢阈值”。为了确定葡萄糖参数是否存在类似关系，我们对六个数据库进行了系统检索，涵盖从数据库建立至2022年6月的所有纵向研究，这些研究直接考察了接受APs治疗的SCZ患者中葡萄糖相关指标变化与精神病理学变化之间的关系。我们确定了10项相关研究以及另一项考虑了认知因素的研究。在大多数情况下，我们发现治疗后空腹血糖和胰岛素水平升高与临床改善相关。这些发现为现有文献提供了补充，这些文献可能提示了APs作用与代谢副作用之间的共同机制，并支持有必要开展更多工作以探索SCZ中葡萄糖-精神病理学关系的有效性。
