Metabolic Side Effects of Second Generation Antipsychotics: A Comparative Cross-Sectional Study
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Date
2015-11
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Addis Ababa University
Abstract
Background
There is evidence that people with mental illness are more likely to suffer from
metabolic syndrome compared to the general population, especially those taking
second generation antipsychotics (SGAs). However, there is dearth of data
comparing the metabolic side effects of first generation and second generation
antipsychotics. SGAs are also newly introduced in the Ethiopian setting. The
objective of this study was to explore the potential metabolic side effect of SGAs.
Method
Design: A cross sectional study, comparing the prevalence of metabolic syndrome
in patients with severe mental illness taking FGAs or SGAs (for at least 6weeks)
Setting: Study was conducted at Amanuel Specialized Mental Hospital in Ethiopia
and participants were recruited from the inpatient departments.
Participants: An initial sample size of 150 was required for the detection of a 50%
difference in the rate of metabolic syndrome between SGAs and FGAs at a 1:1
allocation ratio. However, only one hundred participants were recruited because
SGAs were often running out off stock and took longer than anticipated to get
adequate number on SGAs. However, candidate believes 100 participants would be
adequate for this kind of exploratory and hypothesis generating study.
Measurement: Data on basic demographics, including relevant family history,
dietary habit, clinical information (diagnosis, duration of illness and medication) and
metabolic profile was collected. Diagnosis of metabolic syndrome was made
according to the criteria of the International Diabetes Federation.
Analysis: Focused on simple descriptive approaches with limited bivariate analysis.
Result
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In the 4month study period 100 participants were included, who fulfilled the inclusion
criteria. For ease of access, all participants were inpatients. Sixty six percent (n=66)
were male and 34% (n=34) were female. The mean age of the patients was
31.1years (SD 9.7). Fifty four (n=54) percent of the participants were prescribed
SGA and 46 of the participants were prescribed FGA. According to IDF criteria 8.5%
(n= 8) met the diagnostic criteria for metabolic syndrome. The prevalence of
metabolic syndrome in FGA group was 2.3% and SGA group was 14%. (Crude OR=
7; 95% CI = 0.82, 59.3; P = .074).
Conclusion
Overall, the prevalence of metabolic syndrome is relatively low, especially among
those taking FGAs. Although the study failed to find statistically significant difference
between those taking SGAs and FGAs, there was a strong trend of association
between SGAs and metabolic syndrome.
Further confirmatory studies are required; however, taken together with the broader
literature regarding SGAs and metabolic syndromes, careful screening and
monitoring has to be part of standard clinical practice.
Introduction
Description
Keywords
Metabolic, Antipsychotics