Metabolic Side Effects of Second Generation Antipsychotics: A Comparative Cross-Sectional Study

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Addis Ababa University


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 5 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



Metabolic, Antipsychotics