Impact of Psychotropic Medication Effects on Obesity and the Metabolic Syndrome in People With Serious Mental Illness

Mazereel, Victor; Detraux, Johan; Vancampfort, Davy; Winkel, Ruud van

doi:10.3389/fendo.2020.573479

Cited by 100 publications

(103 citation statements)

References 132 publications

(198 reference statements)

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“…In addition, findings have supported the critical roles of low-grade systemic inflammation, elevated oxidative and nitrosidative stress in depression and MetS [ 65 ]. Thirdly, conventional antidepressants may have direct side effects on MetS and its components [ 69 ]. For instance, tricyclic antidepressant (TCA) use increased the risk of MetS and weight gain [ 70 ].…”

Section: Discussionmentioning

confidence: 99%

The association between depression and metabolic syndrome and its components: a bidirectional two-sample Mendelian randomization study

Zhang

Chen

Yin³

et al. 2021

Transl Psychiatry

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Observational studies suggested a bidirectional correlation between depression and metabolic syndrome (MetS) and its components. However, the causal associations between them remained unclear. We aimed to investigate whether genetically predicted depression is related to the risk of MetS and its components, and vice versa. We performed a bidirectional two-sample Mendelian randomization (MR) study using summary-level data from the most comprehensive genome-wide association studies (GWAS) of depression (n = 2,113,907), MetS (n = 291,107), waist circumference (n = 462,166), hypertension (n = 463,010) fasting blood glucose (FBG, n = 281,416), triglycerides (n = 441,016), high-density lipoprotein cholesterol (HDL-C, n = 403,943). The random-effects inverse-variance weighted (IVW) method was applied as the primary method. The results identified that genetically predicted depression was significantly positive associated with risk of MetS (OR: 1.224, 95% CI: 1.091–1.374, p = 5.58 × 10−4), waist circumference (OR: 1.083, 95% CI: 1.027–1.143, p = 0.003), hypertension (OR: 1.028, 95% CI: 1.016–1.039, p = 1.34 × 10−6) and triglycerides (OR: 1.111, 95% CI: 1.060–1.163, p = 9.35 × 10−6) while negative associated with HDL-C (OR: 0.932, 95% CI: 0.885–0.981, p = 0.007) but not FBG (OR: 1.010, 95% CI: 0.986–1.034, p = 1.34). No causal relationships were identified for MetS and its components on depression risk. The present MR analysis strength the evidence that depression is a risk factor for MetS and its components (waist circumference, hypertension, FBG, triglycerides, and HDL-C). Early diagnosis and prevention of depression are crucial in the management of MetS and its components.

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Section: Discussionmentioning

confidence: 99%

The association between depression and metabolic syndrome and its components: a bidirectional two-sample Mendelian randomization study

Zhang

Chen

Yin³

et al. 2021

Transl Psychiatry

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“…Moreover, to date, many interventions are confined to a single study, precluding pooled data or comparisons between interventions. Our review restricted the population to schizophrenia patients, even though antipsychotics are used to treat patients with other psychiatric illnesses such as affective disorders who also share the metabolic burden ( 82 ) and may benefit from the reviewed interventions. Finally, while behavioral and lifestyle interventions remain first-line treatments for dyslipidemia, our review restricted the search to pharmacological interventions.…”

Section: Discussionmentioning

confidence: 99%

Pharmacological Interventions to Treat Antipsychotic-Induced Dyslipidemia in Schizophrenia Patients: A Systematic Review and Meta Analysis

et al. 2021

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Introduction: Antipsychotic-induced dyslipidemia represents a common adverse effect faced by patients with schizophrenia that increases risk for developing further metabolic complications and cardiovascular disease. Despite its burden, antipsychotic-induced dyslipidemia is often left untreated, and the effectiveness of pharmacological interventions for mitigating dyslipidemia has not been well-addressed. This review aims to assess the effectiveness of pharmacological interventions in alleviating dyslipidemia in patients with schizophrenia.Methods: Medline, PsychInfo, and EMBASE were searched for all relevant English articles from 1950 to November 2020. Randomized placebo-controlled trials were included. Differences in changes in triglycerides, HDL cholesterol, LDL cholesterol, and VLDL cholesterol levels between treatment and placebo groups were meta-analyzed as primary outcomes.Results: Our review identified 48 randomized controlled trials that comprised a total of 3,128 patients and investigated 29 pharmacological interventions. Overall, pharmacological interventions were effective in lowering LDL cholesterol, triglycerides, and total cholesterol levels while increasing the levels of HDL cholesterol. Within the intervention subgroups, approved lipid-lowering agents did not reduce lipid parameters other than total cholesterol level, while antipsychotic switching and antipsychotic add-on interventions improved multiple lipid parameters, including triglycerides, LDL cholesterol, HDL cholesterol, and total cholesterol. Off label lipid lowering agents improved triglycerides and total cholesterol levels, with statistically significant changes seen with metformin.Conclusion: Currently available lipid lowering agents may not work as well in patients with schizophrenia who are being treated with antipsychotics. Additionally, antipsychotic switching, antipsychotic add-ons, and certain off label interventions might be more effective in improving some but not all associated lipid parameters. Future studies should explore novel interventions for effectively managing antipsychotic-induced dyslipidemia.Registration: PROSPERO 2020 CRD42020219982; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020219982.

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“…7,25 Compared with the general population, people with severe mental illness are more likely to be obese or have physical diseases, such as cardiovascular diseases, type 2 diabetes, and respiratory tract diseases, all risk factors for worse COVID-19-related outcomes. 26,27 Furthermore, the prevalence of smoking is up to two to three times higher in people with severe mental illness than in people without psychiatric illness. [28][29][30][31] SARS-CoV-2 uses the angiotensin-converting enzyme 2 (ACE2) receptor to gain access into cells and cause infection.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 vaccination for people with severe mental illness: why, what, and how?

Mazereel

Assche

Detraux

et al. 2021

The Lancet Psychiatry

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137

153

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Psychiatric disorders, and especially severe mental illness, are associated with an increased risk of severe acute respiratory syndrome coronavirus 2 infection and COVID-19-related morbidity and mortality. People with severe mental illness should therefore be prioritised in vaccine allocation strategies. Here, we discuss the risk for worse COVID-19 outcomes in this vulnerable group, the effect of severe mental illness and psychotropic medications on vaccination response, the attitudes of people with severe mental illness towards vaccination, and, the potential barriers to, and possible solutions for, an efficient vaccination programme in this population.

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Impact of Psychotropic Medication Effects on Obesity and the Metabolic Syndrome in People With Serious Mental Illness

Cited by 100 publications

References 132 publications

The association between depression and metabolic syndrome and its components: a bidirectional two-sample Mendelian randomization study

The association between depression and metabolic syndrome and its components: a bidirectional two-sample Mendelian randomization study

Pharmacological Interventions to Treat Antipsychotic-Induced Dyslipidemia in Schizophrenia Patients: A Systematic Review and Meta Analysis

COVID-19 vaccination for people with severe mental illness: why, what, and how?

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