Improvement of Metabolic Risk Profile under Second-Generation Antipsychotics: A Pilot Intervention Study

Abstract

Objective:To assess the impact of a weight management program on metabolic health of second-generation antipsychotic (SGA)-treated patients.Methods: A prospective 12-week intervention program including individual exercise training and nutritional group sessions was performed as a pilot study. An intervention group of 6 SGA-treated patients (5 men and 1 woman; mean 15.0, SD 11.8 months) was compared with 10 reference patients under SGAs (8 men and 2 women; mean 14.0, SD 14.2 months), presenting similar age and baseline weekly levels of physical activity. For patients of both groups, anthropometric measurements and basic fasting lipid profile were assessed. For patients in the intervention group, an adapted Rockport Test was performed to evaluate their aerobic fitness and compliance to training sessions, and was recorded.Results: After the 12-week period, reference patients significantly gained weight (P = 0.001), whereas intervention patients showed significant weight loss and decreased body mass index (P = 0.02); interaction between groups: P < 0.01. This weight loss was accompanied by a decreased cholesterol-high-density lipoprotein cholesterol ratio (P = 0.04). Overall, the intervention patients' adherence to exercise prescription was 95.1 %, and this adherence induced a significant improvement of their aerobic fitness (P = 0.05). Conclusion Limitations· This pilot intervention study was not randomized and was completed with a small sample size. · Patients were not treated for dyslipidemia, diabetes, or obesity whereas treatment with concomitant medication for depression, anxiety, and (or) mood disorders were not considered as exclusion criteria. · No information was collected on level of physical activities or dietary habits of the patients during the intervention program.

Effects of high aerobic intensity training in patients with schizophrenia—A controlled trial

“…Studies on patients with schizophrenia have usually investigated low-intensity exercise corresponding to <70% peak heart rate (HR peak ) (14-17). Only a few studies have applied direct measurements of oxygen uptake (18-20), but the exact level of VO 2peak are not described.…”

How can we increase physical activity and exercise among youth experiencing first‐episode psychosis? A systematic review of intervention variables

“…19 In total, 12 interventions were included as one study utilized two separate intervention groups. 19 The majority of the interventions were delivered over 12 weeks, 14,[17][18][19]21,22 with the longest intervention spanning 18 months. 13 The range of weekly sessions was 0-3.…”

“…19 Four of the identified studies stated that university-trained kinesiologists or exercise physiologists supervised the interventions. 14,16,21,22 Five studies (45%) assessed aerobic capacity (VO2 max or VO2 peak) 16,17,19,21,22 as an outcome measure whereas four studies assessed self-reported physical activity, predominantly using the International Physical Activity Questionnaire-Short Form. 14,[20][21][22]…”

“…Trials were primarily excluded if they were not specifically targeting FEP, rather schizophrenia spectrum disorders or psychotic disorders more broadly. Of the 11 identified studies, 4 were study protocols, 2 were pilot studies, 3 were randomized controlled trials and 2 were prospective interventional studies …”

Efeito de um programa de atividade física na destreza manual e na assimetria manual de indivíduos com esquizofrenias

“…Estudos anteriores revelam que a participação em programas de AF regular possibilita aos indivíduos com esquizofrenia diminuir o peso (5,7,19,43) , o índice de massa corporal (5-7, 19, 43) , e a circunferência da cintura (43) , bem como, melhorar a capacidade funcional para o exercício (38) , a capacidade cardiorrespiratória (6,42) , determinadas variáveis psicológicas (e.g., autoestima, controlo emocional, funções sociais) (10,21,42) e a qualidade de vida (1,21,27) . Julgamos que o nosso estudo, apesar de se tratar de um estudo piloto com algumas limitações metodológicas, poderá contribuir para um melhor entendimento da importância da AF na DM de indivíduos com esquizofrenia.…”