Combination therapy as a potential risk factor for the development of type 2 diabetes in patients with schizophrenia: the GOMAP study

BMC Psychiatry

Fragiskos Gonidakis¹  Athina Karabela²  Ioannis Serafetinidis³  George Dedoussis⁴  Anastasia Thanopoulou⁵  Eirini Glezou⁶  Eleni Zengini⁶  Vassilis Kontaxakis⁷  Nikolaos Tentolouris⁸  Vasiliki Mamakou⁹  Klea Lamnissou^1,10  Evgenia Tsompanaki^1,11  Nigel W. Rayner^1,12  Karoline Kuchenbaecker^1,12  Eleftheria Zeggini^1,12  Lorraine Southam^1,12  Bram Prins^1,12  Sophie Hackinger^1,12  Eirini Marouli^1,13 

[1] 1st Psychiatric Department, Eginition Hospital, Medical School, National and Kapodistrian University of Athens;Dafni Psychiatric Hospital;Department of Gastroenterology, Gennimatas General Hospital;Department of Nutrition-Dietetics, Harokopio University;Diabetes Centre, 2nd Department of Internal Medicine, Hippokration General Hospital, Medical School, National and Kapodistrian University of Athens;Dromokaiteio Psychiatric Hospital;Early Psychosis Unit, 1st Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens;First Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens, Medical School, Laiko General Hospital;Medical School, National and Kapodistrian University Athens;National and Kapodistrian University of Athens, Department of Biology, Athens, Panepistimioupolis;School of Information Sciences and Technology, Department of Statistics, Athens University of Economics and Business;Wellcome Sanger Institute;William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London;

关键词: Type 2 diabetes;    Schizophrenia;    First generation antipsychotics;    Second generation antipsychotics;    Antidepressants;    Mood stabilizers;   

DOI  :  10.1186/s12888-018-1826-4

来源: DOAJ

【 摘 要 】

Abstract Background Schizophrenia (SCZ) is associated with increased risk of type 2 diabetes (T2D). The potential diabetogenic effect of concomitant application of psychotropic treatment classes in patients with SCZ has not yet been evaluated. The overarching goal of the Genetic Overlap between Metabolic and Psychiatric disease (GOMAP) study is to assess the effect of pharmacological, anthropometric, lifestyle and clinical measurements, helping elucidate the mechanisms underlying the aetiology of T2D. Methods The GOMAP case-control study (Genetic Overlap between Metabolic and Psychiatric disease) includes hospitalized patients with SCZ, some of whom have T2D. We enrolled 1653 patients with SCZ; 611 with T2D and 1042 patients without T2D. This is the first study of SCZ and T2D comorbidity at this scale in the Greek population. We retrieved detailed information on first- and second-generation antipsychotics (FGA, SGA), antidepressants and mood stabilizers, applied as monotherapy, 2-drug combination, or as 3- or more drug combination. We assessed the effects of psychotropic medication, body mass index, duration of schizophrenia, number of hospitalizations and physical activity on risk of T2D. Using logistic regression, we calculated crude and adjusted odds ratios (OR) to identify associations between demographic factors and the psychiatric medications. Results Patients with SCZ on a combination of at least three different classes of psychiatric drugs had a higher risk of T2D [OR 1.81 (95% CI 1.22–2.69); p = 0.003] compared to FGA alone therapy, after adjustment for age, BMI, sex, duration of SCZ and number of hospitalizations. We did not find evidence for an association of SGA use or the combination of drugs belonging to two different classes of psychiatric medications with increased risk of T2D [1.27 (0.84–1.93), p = 0.259 and 0.98 (0.71–1.35), p = 0.885, respectively] compared to FGA use. Conclusions We find an increased risk of T2D in patients with SCZ who take a combination of at least three different psychotropic medication classes compared to patients whose medication consists only of one or two classes of drugs.

【 授权许可】

Unknown