The risk for cardiovascular disease in people with psychosis increases after their first exposure to antipsychotic drugs, according to new research published online February 7 in the Archives of General Psychiatry.
“This change in risk is evident early in the course of treatment, within several weeks of continuous use, but may continue over years,” study investigator Debra L. Foley, PhD, of the University of Melbourne in Australia, told Medscape Medical News.
Schizophrenia is associated with a reduced life expectancy, and most early deaths are due to cardiovascular disease.
“We wanted to review what was known about the role of antipsychotic drugs in altering early risk factors for cardiovascular disease,” Dr. Foley explained.
Dr. Foley and coauthor Katherine I. Morley, PhD, from the Wellcome Trust Sanger Institute, Hinxton, United Kingdom, undertook a systematic review of baseline and posttreatment risk factors for cardiovascular disease in patients receiving drug treatment for psychosis for the first time. The analysis included 25 studies published between January 1990 and June 2010.
All subjects were experiencing their first treated episode of psychosis and were either antipsychotic naive or had been exposed to antipsychotics for between 9 days and 16 weeks. Eight of the studies also included controls that were recruited from hospital staff, universities, the general community, and a workplace-screening program.
Rapid Metabolic Change
The investigators found that changes in weight, body mass index, and waist circumference were evident in the patients receiving the antipsychotic drugs after 1 month.
After 6 weeks, there was a significant increase in interleukin 12. After 10 weeks, there was a significant increase in subcutaneous and intra-abdominal fat, a 3-fold increase in leptin level, and a significant increase in total and low-density lipoprotein cholesterol, triglyceride, and nonfasting glucose levels.
After 6 to 12 months, total body weight increased by 10% to 12%, and most of this increase occurred in the first 6 months. Between 36% and 42% of patients were overweight or obese at baseline, the same as in the broader community, but after 6 months, 58% to 71% were overweight or obese, the study authors report…….
Reported by Fran Lowry
Medscape Medical News