The comparison of glucose and lipid metabolism parameters in drug-naïve, antipsychotic-treated, and antipsychotic discontinuation patients with schizophrenia

Abstract

BackgroundAlthough many studies have reported that glucose and lipid metabolism disorders are a significant side effect associated with the use of antipsychotic drugs, the characteristics of glucose and lipid metabolism disorders in patients with schizophrenia who are taking antipsychotic drugs remain poorly understood, and the possible effects that antipsychotic discontinuation may have on glucose and lipid metabolism remain unclear.MethodsThe sample consisted of 131 Chinese patients with schizophrenia, including 70 first-episode, drug-naïve patients; 33 patients who had received continuous antipsychotic drug treatment for ≥1 year prior to the beginning of the study; and 28 patients who had discontinued antipsychotic drug treatment for ≥3 months prior to the beginning of study. We compared the glucose and lipid metabolic parameter levels among the three groups of patients with schizophrenia. All assessments were performed upon hospital admission.ResultsThe characteristics of glucose and lipid metabolism disorders in Chinese patients with schizophrenia who are taking antipsychotic drugs included significant augmentation of the body mass index and waist circumference, significantly higher levels of fasting plasma insulin and insulin resistance, and significantly lower plasma high-density lipoprotein cholesterol levels. Antipsychotic discontinuation appeared to not significantly improve any plasma glucose and lipid metabolic parameter levels.ConclusionThe results suggest that antipsychotic drugs aggravate glucose and lipid metabolism disorders and that antipsychotic discontinuation is generally not associated with improvements in the parameters that indicate glucose and lipid metabolism disorders in Chinese patients with schizophrenia.

Treatment Discontinuation Impact on Long-Term (10-Year) Weight Gain and Lipid Metabolism in First-Episode Psychosis: Results From the PAFIP-10 Cohort

“…Similarly, discontinuation of antipsychotic treatment in a small group of hospitalized children and adolescents ( Hulvershorn et al, 2017 ) was associated with reductions in BMI. And Wu and colleagues ( Wu et al, 2014 ) observed that antipsychotic discontinuation patients presented a smaller BMI (23.09 vs 22.28) than the antipsychotic-treated schizophrenia patients, although the differences did not reach statistical significance. In this case, the lack of statistical significance in the results might be explained by the fact that the mean duration of treatment discontinuation prior to the study was 0.67 years, probably not long enough to reverse the previous long-term metabolic effect of antipsychotic treatment.…”

“…Despite this, Mackin and colleagues ( Mackin et al, 2012 ) reported that discontinuing antipsychotic medication after several years of exposure was not associated with a reversal of the metabolic disturbances presented in the patients, suggesting that the consolidated metabolic dysregulation associated with the antipsychotic treatment is maintained long term ( Mackin et al, 2012 ). Similarly, Wu and colleagues ( Wu et al, 2014 ) reported that compared with antipsychotic-treated schizophrenia patients, antipsychotic-discontinuation patients showed a smaller BMI, although the differences did not reach statistical significance.…”

Comparison of Elixhauser and Charlson Methods for Discriminative Performance in Mortality Risk in Patients with Schizophrenic Disorders

“…The weight assigned to each comorbid condition ranged from one to six and the individual score for each of these conditions contributed to the final score. The CCIS has been used extensively to evaluate the impact of comorbid conditions in a variety of conditions [2][3][4]. CCIS has been modified in several ways including by a reduction in the number of conditions considered from 19 to 17 [5] and the use of coding by specific International Classification of Diseases, Clinical Modifications (ICD-CM) diagnosis codes [6].…”

“…It incorporates thirty comorbid conditions and has been validated in acute-care inpatient hospital settings using administrative data [8]. A growing number of studies have suggested that the Elixhauser method is a better comorbidity risk-adjustment model than CCIS [4,9].…”

Schizophrenia and obesity: May the gut microbiota serve as a link for the pathogenesis?

“…According to the clinical data from our group, patients with first‐episode SZ exhibited glucolipid metabolic abnormalities before receiving antipsychotic medication [ 37 ]. The use of antipsychotics further worsened the insulin resistance and related metabolic disorders in SZ patients [ 38 ]. Moreover, the discontinuation of antipsychotic medication was not associated with improvement of glucolipid metabolic disturbance in these patients [ 39 ].…”