Is antipsychotic polypharmacy associated with metabolic syndrome even after adjustment for lifestyle effects?: a cross-sectional study

BMC Psychiatry

Research Article

Haruo Kashima¹  Yasuyuki Okumura²  Hiroto Ito²  Keiko Shimizu³  Mami Kayama⁴  Yasuo Fujii⁵  Fumio Koshiishi⁵  Yoshiyo Oguchi⁵  Mihoko Kobayashi⁵  Ryouji Miyata⁵  Hirokazu Shida⁵  Fuminari Misawa⁵ 

[1] Department of Psychiatry, Neuropsychiatry, Keio University, School of Medicine, 35 Shinano-machi, Shinjuku-ku, 160-8582, Tokyo, Japan;Department of Social Psychiatry, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-machi, Kodaira-shi, Tokyo, Japan;Faculty of Nursing, Yamanashi Prefectural University, 1-6-1 Ikeda, Koufu-shi, Yamanashi, Japan;Psychiatric & mental Health Nursing, St. Luke's College of Nursing, 10-1 Akasi-cho, Chuo-ku, Tokyo, Japan;Yamanashi Prefectural KITA Hospital, 3314-13 Kamijominamiwari, Asahi-machi, Nerasaki-shi, Yamanashi, Japan;

关键词: Physical Activity;    Schizophrenia;    Metabolic Syndrome;    Clozapine;    Olanzapine;   

DOI  :  10.1186/1471-244X-11-118

 received in 2010-08-01, accepted in 2011-07-26,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundAlthough the validity and safety of antipsychotic polypharmacy remains unclear, it is commonplace in the treatment of schizophrenia. This study aimed to investigate the degree that antipsychotic polypharmacy contributed to metabolic syndrome in outpatients with schizophrenia, after adjustment for the effects of lifestyle.MethodsA cross-sectional survey was carried out between April 2007 and October 2007 at Yamanashi Prefectural KITA hospital in Japan. 334 patients consented to this cross-sectional study. We measured the components consisting metabolic syndrome, and interviewed the participants about their lifestyle. We classified metabolic syndrome into four groups according to the severity of metabolic disturbance: the metabolic syndrome; the pre-metabolic syndrome; the visceral fat obesity; and the normal group. We used multinomial logistic regression models to assess the association of metabolic syndrome with antipsychotic polypharmacy, adjusting for lifestyle.ResultsSeventy-four (22.2%) patients were in the metabolic syndrome group, 61 (18.3%) patients were in the pre-metabolic syndrome group, and 41 (12.3%) patients were in visceral fat obesity group. Antipsychotic polypharmacy was present in 167 (50.0%) patients. In multinomial logistic regression analyses, antipsychotic polypharmacy was significantly associated with the pre-metabolic syndrome group (adjusted odds ratio [AOR], 2.348; 95% confidence interval [CI], 1.181-4.668), but not with the metabolic syndrome group (AOR, 1.269; 95%CI, 0.679-2.371).ConclusionsThese results suggest that antipsychotic polypharmacy, compared with monotherapy, may be independently associated with an increased risk of having pre-metabolic syndrome, even after adjusting for patients' lifestyle characteristics. As metabolic syndrome is associated with an increased risk of cardiovascular mortality, further studies are needed to clarify the validity and safety of antipsychotic polypharmacy.

【 授权许可】

CC BY   
© Misawa et al; licensee BioMed Central Ltd. 2011