Antipsychotics Raise Need for Health Checks


BARCELONA — More than 20% of patients taking antipsychotic medications for schizophrenia were at risk for diabetes, more than 30% had undiagnosed hyperlipidemia, and more than 50% had undiagnosed hypertension, a large European epidemiologic study has found.

The findings drive home the need for continuous monitoring of patients taking these drugs, Dr. Marc de Hert and his colleagues wrote in a poster presented at the annual congress of the European College of Neuropsychopharmacology.

The observational study was launched in 2006; it included 2,270 patients with schizophrenia recruited in 12 European countries. Patients made a single clinic visit, during which they underwent a metabolic workup that included measurement of fasting blood glucose, weight, waist, hips, and blood pressure. The patients' median age was 41; 55% were male. Most (76%) had paranoid schizophrenia; the median duration of illness was 11 years.

The most frequently used typical antipsychotics were haloperidol (48%) and zuclopenthixol (20%). The most frequently used atypicals were risperidone (25%), olanzapine (23%), clozapine (19%), amisulpride (17%), and quetiapine (12%).

Only 4% of the patients had a diagnosis of diabetes, yet an additional 24% either had or were at risk of the disorder, wrote Dr. de Hert of the Catholic University Louvain (Belgium). Of these 559 patients, 75 had a fasting blood glucose of at least 126 mg/dL, consistent with diabetes, and 484 presented with an impaired fasting glucose of 100–126 mg/dL. Seven percent (161) previously had been diagnosed with hyperlipidemia. However, an additional 54% of the cohort had undiagnosed hyperlipidemia at the time of the exam.

Hypertension previously had been diagnosed in 248 patients. But at the study visit, an additional 738 patients (32%) had elevated blood pressures; elevations were significantly more likely in those taking a typical than an atypical antipsychotic.

The incidence of metabolic syndrome was similar in both groups (37%).

This study was sponsored and funded by Sanofi-Aventis.

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