Background Second-generation antipsychotics (SGAs) have improved the treatment of psychiatric disorders. Nevertheless, their use is associated with the development of metabolic disorders, which increase premature cardiovascular mortality.
Purpose To describe the prevalence of metabolic disorders in patients treated with SGAs and analyse if these comorbidities were properly monitored.
Material and methods A prospective, observational study was conducted in a tertiary hospital from March to April 2018. Inclusion criteria were: age ≥18 years, psychiatric patients with chronic treatment with SGAs (clozapine, olanzapine, quetiapine, ziprasidone, paliperidone and risperidone) and admission in a psychiatric ward.
We collected sociodemographic (gender, age, alcohol, tobacco, diagnosis), pharmacotherapeutic (treatment with SGAs, antihypertensive drugs (AD) and lipid-lowering drugs (LLD)) and metabolic variables (body mass index, glucose level (GL), total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and prolactin levels (PL). Metabolic variables were considered altered when: GL >126 mg/dL, TC >200 mg/dL, LDL >100 mg/dL, HDL <40 mg/dL, TG >150 mg/dL and PL >25 ng/mL in females and >20 ng/mL in males. Data were collected from the electronic medical record.
Results During the study period, 51 patients were included. The average age was 39 years±25 (50.9% females). 31.6% were smokers, 47.1% habitual alcohol consumers and 23.5% were treated with AD and/or LLD. The main diagnoses were schizophrenia (35%) followed by depression (16%).
From the total number of patients, 78.4% presented with some altered metabolic parameter. Thirty per cent of the patients were obese and 58.8% were overweight. GL were altered in 11% of patients, none were in treatment. From patients treated with LLD, 52% had some altered lipid parameter (14% TC, 52% LDL and 25% TG) and 82% of patients without LLD had some altered lipid parameter (36% TC, 82% LDL and 45% TG). Finally, females presented with 50% pathological PL and males 40%. A high number of patients (57%) did not have their PL checked during treatment.
Conclusion A high prevalence of metabolic disorders in patients treated with SGAs was observed and a large percentage of patients were not being properly monitored. Therefore, pharmaceutical care could help to achieve improved health outcomes in psychiatric patients.
References and/or acknowledgements No conflict of interest.