2008 issue 3


Volume 17, issue 3

Original article

Metabolic syndrome and its components in patients with first-episode schizophrenia before and after a 1-year antipsychotic treatment

Jolanta Rabe-Jabłońska1, Anna Dietrich-Muszalska1, Grzegorz Nawarski2, Tomasz Pawełczyk1
1. Klinika Zaburzeń Afektywnych i Psychotycznych Katedry Psychiatrii Uniwersytetu Medycznego w Łodzi
2. SPZOZ w Poddębicach
Postępy Psychiatrii i Neurologii 2008; 17 (3): 195-200
Keywords: first-episode schizophrenia, metabolic syndrome, antipsychotic treatment


Objective. The aim of the study was to evaluate the prevalence of metabolic syndrome (MS) and its components in young patients diagnosed with first-episode schizophrenia, before and after a 1-year antipsychotic treatment with the same neuroleptic.
Methods. Participants in the study were 30 patients aged 16-21, with the first episode of schizophrenia and no other mental and somatic disorders (ICD-10), never treated with antipsychotics previously. They were examined before and after a 1-year treatment with a single neuroleptic; during the treatment they received no other psychotropic drugs. At baseline and on the treatment completion their fasting glucose level, total cholesterol, its fractions (HDL-C, LDL-C) and TG levels, waist circumference, body weight, and blood pressure were measured. The results were compared with these obtained in a diagnostically similar Polish population (EUFEST) and in the general population of Poland (NATPOL PLUS).
Results. At baseline none of the patients had MS, and the prevalence of MS components was lower than both in the in EUFEST sample and in the general population. After the 1-year antipsychotic treatment 10% of the patients were diagnosed with MS. The number of patients diagnosed with more than two MS components among those treated with LPIIG increased, indicating a higher risk of developing MS by the young patients. Over 2/3 of the patients gained in body weight, while an >5% increase in the baseline weight was found in " of this group. In about 1/3 of the patients waist circumference was above the norm, and this was usually associated with a pathological lipid profile. This phenomenon was found both in patients treated with typical neuroleptics and in those receiving second-generation antipsychotics, but the most frequent and conspicuous body weight increments followed olanzapine treatment. While none of the patients displayed carbohydrate metabolism impairment before treatment, after treatment this condition was found in a single case only.
Conclusions. The data suggest that risk factors for MS should be assessed prior to pharmacotherapy, appropriate antipsychotic medication should be selected with due caution, patients and their caregivers should be educated about the need for adequate diet and physical activity, and the patients' waist circumference as well as laboratory parameters should be monitored during pharmacological treatment.

Address for correspondence:
Prof. Jolanta Rabe-Jabłońska
Klinika Zaburzeń Afektywnych i Psychotycznych UM
ul. Czechosłowacka 8/10, 92-216 Łódź
tel. 042 675 73 71
fax: 042 675 74 03
e-mail: jabl@csk. am. lodz.pl