Influence of antipsychotics on metabolic syndrome risk in patients with schizophrenia

Front Psychiatry. 2022 Jul 25:13:925757. doi: 10.3389/fpsyt.2022.925757. eCollection 2022.

Authors

Aleksandra Koricanac^{1

2}, Aleksandra Tomic Lucic^{3

4}, Mirjana Veselinovic^{3

4}, Danijela Bazic Sretenovic^{3

4}, Gorica Bucic^{3

4}, Anja Azanjac^{3

4}, Olivera Radmanovic⁴, Mirjana Matovic^{1

2}, Marijana Stanojevic^{5

6}, Aleksandra Jurisic Skevin⁷, Bojana Simovic Markovic⁸, Jelena Pantic⁸, Nebojša Arsenijevic⁸, Gordana D Radosavljevic⁸, Maja Nikolic⁹, Nenad Zornic^{10

11}, Jelena Nesic^{3

12}, Nemanja Muric^{13

14}, Branimir Radmanovic^{13

14}

Affiliations

¹ Department of Internal Medicine, General Hospital Kraljevo, Kraljevo, Serbia.
² Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
³ Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
⁴ Clinic for Rheumatology and Allergology, University Clinical Center Kragujevac, Kragujevac, Serbia.
⁵ Department of Biochemistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
⁶ Department of Laboratory Diagnostics, University Clinical Center Kragujevac, Kragujevac, Serbia.
⁷ Department of Physical Medicine and Rehabilitation, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
⁸ Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
⁹ Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
¹⁰ Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
¹¹ Department for Anesthesiology and Reanimation, University Clinical Center Kragujevac, Kragujevac, Serbia.
¹² Clinic for Endocrinology, University Clinical Center Kragujevac, Kragujevac, Serbia.
¹³ Department of Psychiatry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
¹⁴ Psychiatry Clinic, University Clinical Center Kragujevac, Kragujevac, Serbia.

Abstract

Objective: Many studies so far have shown that antipsychotic therapy may have an effect on the development of metabolic syndrome in patients diagnosed with schizophrenia. Our goal was to determine whether our respondents are at risk for developing metabolic syndrome and who is more predisposed to it.

Methods: In a stable phase, 60 patients diagnosed with schizophrenia were equally divided into three groups according to the drug (risperidone, clozapine, and aripiprazole monotherapy). Control group had 20 healthy examinees. Patients were evaluated first using The Positive and Negative Syndrome Scale (PANSS). Prolactin, lipid status, glycemia, insulin, cytokine values (IL-33, TGF-β, and TNF-α) and C-reactive protein (CRP) were measured. Also, Body mass index (BMI), Homeostatic Model Assesment for Insulin Resistance (HOMA index), waist and hip circumference (WHR) and blood pressure (TA) measurement were performed in the study.

Results: Patients treated with risperidone compared to healthy control subjects and aripiprazol group of patients had statistically significant difference in prolactin levels. In clozapine group compared to healthy control group values of HDL cholesterol and glucose level were statistically significant different. In aripiprazole group compared to healthy control group value of BMI was statistically significant different. Statistically significant correlations were found in TNF-α with glucose and HOMA index in risperidone treated patients and with BMI in clozapine group of patients; IL-33 with glucose in risperidone and with BMI in clozapine group of patients and TGF-β with glucose in risperidone group, with insulin and HOMA index in clozapine group and statistically significant negative correlation with LDL cholesterol in aripiprazole group of patients.

Conclusion: Patients on risperidone and clozapine therapy may be at greater risk of developing metabolic syndrome than patients treated with aripiprazole. Statistically significant difference in concentration of TNF-α and TGF-β was in the group of patients treated with risperidone compared to healthy control group.

Keywords: aripiprazole; clozapine; cytokine; metabolic syndrome; risperidone; schizophrenia.

Copyright © 2022 Koricanac, Tomic Lucic, Veselinovic, Bazic Sretenovic, Bucic, Azanjac, Radmanovic, Matovic, Stanojevic, Jurisic Skevin, Simovic Markovic, Pantic, Arsenijevic, Radosavljevic, Nikolic, Zornic, Nesic, Muric and Radmanovic.