Incidence of hypercholesterolaemia and hyperglycaemia in schizophrenic patients: Atypical antipsychotic medication and clinical variables
DOI:
https://doi.org/10.46542/pe.2024.242.2331Keywords:
Atypical antipsychotic, Hypercholesterolemia, Hyperglycemia, SchizophreniaAbstract
Background: Atypical or second-generation antipsychotic drugs commonly used in the management of schizophrenia include risperidone. Risperidone is linked to the incidence of metabolic syndrome-related adverse effects.
Objective: This study aims to investigate the correlation between the administration of risperidone therapy and the incidence of metabolic syndrome in outpatients diagnosed with schizophrenia. This inquiry involves an examination of relevant laboratory parameters, specifically cholesterol, blood glucose, and haemoglobin A1c (HbA1C) levels, alongside an evaluation of pertinent clinical variables that may exert an influence.
Methods: This study adopted a cross-sectional approach to receiving risperidone therapy for a minimum of three months at Grhasia Mental Hospital in Yogyakarta, Indonesia. Sampling was executed using an accidental sampling technique, targeting patients who met the predefined inclusion criteria.
Results: The study enrolled a total of 97 participants, comprising 58 males and 39 females. Subsequent statistical analyses failed to demonstrate any statistically significant associations between hyperglycemia and various factors, including the risperidone regimen (p = 0.574), risperidone dosage (p = 0.619), and the duration of risperidone therapy (p = 1.000).
Conclusion: Risperidone has a long-term risk of causing hyperglycemia in people with schizophrenia; consequently, blood glucose and HbA1C levels must be monitored on a regular basis.
References
Agaba, D. C., Migisha, R., Namayanja, R., Katamba, G., Lugobe, H. M., Aheisibwe, H., Twesigomwe, G., & Ashaba, S. (2019). Prevalence and associated factors of metabolic syndrome among patients with severe mental illness attending a tertiary hospital in Southwest Uganda. BioMed Research International, 2019, 1‒8. https://doi.org/10.1155/2019/1096201
American Diabetes Association. (2018). 4. Lifestyle management: Standards of medical care in diabetes—2018. Diabetes Care, 41(1), 38‒50. https://doi.org/10.2337/dc18-S004
Andari, S. (2017). Religious based social services on rehabilitation of schizophrenic patients. Jurnal PKS, 16(2), 195–208.
Arania, R., Triwahyuni, T., Esfandiari, F., & Nugraha, F. R. (2021). The relationship between age, gender and education level and the incidence of diabetes mellitus at the Mardi Waluyo Clinic, Central Lampung. Jurnal Medika Malahayati, 5(3), 146–153. https://doi.org/10.33024/jmm.v5i3.4200
Bernardo, M., Rico-Villademoros, F., García-Rizo, C., Rojo, R., & Gómez-Huelgas, R. (2021). Real-world data on the adverse metabolic effects of second-generation antipsychotics and their potential determinants in adult patients: A systematic review of population-based studies. Advances in Therapy, 38(5), 2491–2512. https://doi.org/10.1007/s12325-021-01689-8
Bruijnzeel, D., Suryadevara, U., & Tandon, R. (2014). Antipsychotic treatment of schizophrenia: An update. Asian Journal of Psychiatry, 11, 3–7. https://doi.org/10.1016/j.ajp.2014.08.002
Campagna, D., Alamo, A., Di Pino, A., Russo, C., Calogero, A. E., Purrello, F., & Polosa, R. (2019). Smoking and diabetes: Dangerous liaisons and confusing relationships. Diabetology & Metabolic Syndrome, 11(1), 85. https://doi.org/10.1186/s13098-019-0482-2
Casey, D. E. (2004). Dyslipidemia and atypical antipsychotic drugs. The Journal of Clinical Psychiatry, 65(suppl 18), 27v35. https://www.psychiatrist.com/read-pdf/5244/
Chang, H.-Y., Yeh, W.-T., Chang, Y.-H., Tsai, K.-S., & Pan, W.-H. (2002). Prevalence of dyslipidemia and mean blood lipid values in Taiwan: Results from the nutrition and health survey in Taiwan (NAHSIT, 1993-1996). The Chinese Journal of Physiology, 45(4), 187–197.
Chisholm-Burns, M. A. (Ed.). (2016). Pharmacotherapy Principles & Practice, Fourth Edition. McGraw-Hill Education.
Correll, C. U., Frederickson, A. M., Kane, J. M., & Manu, P. (2007). Does antipsychotic polypharmacy increase the risk for metabolic syndrome? Schizophrenia Research, 89(1), 91–100. https://doi.org/10.1016/j.schres.2006.08.017
Delacrétaz, A., Vandenberghe, F., Gholam-Rezaee, M., Saigi Morgui, N., Glatard, A., Thonney, J., Solida-Tozzi, A., Kolly, S., Gallo, S. F., Baumann, P., Berney, S., Zulauff, S. V., Aubry, J.-M., Hasler, R., Ebbing, K., von Gunten, A., Conus, P., & Eap, C. B. (2018). Early changes of blood lipid levels during psychotropic drug treatment as predictors of long-term lipid changes and of new onset dyslipidemia. Journal of Clinical Lipidology, 12(1), 219–229. https://doi.org/10.1016/j.jacl.2017.10.002
Dewi, S. S., Nur Lathifah Mardiyati, S. G., & Elida Soviana, S. G. (2015). The relationship between fiber intake and cholesterol levels in outpatients with coronary heart disease at Dr. Hospital. Moewardi Surakarta [Thesis Diploma, Universitas Muhammadiyah Surakarta]. https://eprints.ums.ac.id/37871/
DiPiro, J. T., DiPiro, C. V., Ellingrod, V. L., & Schwinghammer, T. L. (2021). Pharmacotherapy Handbook, Eleventh Edition. McGraw-Hill Education.
Farizah, N. A., Fitriany, E., & Nugrahayu, E. Y. (2020). The relationship between social function and quality of life of outpatient schizophrenia patients at the Atma Husada Mahakam Samarinda Regional Mental Hospital. Motiva: Jurnal Psikologi, 2(2), 43–50. https://doi.org/10.31293/mv.v2i2.4436
Febriani, D., & Febriani, B. (2018). The effect of lifestyle on hypercholesterolemia. The Open Public Health Journal, 11(1), 526–532. https://doi.org/10.2174/1874944501811010526
Gonçalves, P., Araújo, J. R., & Martel, F. (2015). Antipsychotics-induced metabolic alterations: Focus on adipose tissue and molecular mechanisms. European Neuropsychopharmacology: The Journal of the European College of Neuropsychopharmacology, 25(1), 1–16. https://doi.org/10.1016/j.euroneuro.2014.11.008
Guo, Z., L’italien, G. J., Jing, Y., Baker, R. A., Forbes, R. A., Hebden, T., & Kim, E. (2011). A real-world data analysis of dose effect of second-generation antipsychotic therapy on hemoglobin A1C level. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 35(5), 1326–1332. https://doi.org/10.1016/j.pnpbp.2011.03.020
Heald, A., Pendlebury, J., Anderson, S., Narayan, V., Guy, M., Gibson, M., Haddad, P., & Livingston, M. (2017). Lifestyle factors and the metabolic syndrome in Schizophrenia: A cross-sectional study. Annals of General Psychiatry, 16(1), 12. https://doi.org/10.1186/s12991-017-0134-6
Ho, B. L., Lee, W. Y., Chou, Y. C., Chen, Y. C., & Chou, Y. H. (2017). Risk of metabolic syndrome and hyperglycaemia among users of typical and atypical antipsychotics: A retrospective cohort study. Journal of clinical pharmacy and therapeutics, 42(4), 464–471.
Holt, R. I. G. (2019). Association Between Antipsychotic Medication Use and Diabetes. Current Diabetes Reports, 19(10), 96. https://doi.org/10.1007/s11892-019-1220-8
Koller, E. A., Cross, J. T., Doraiswamy, P. M., & Schneider, B. S. (2003). Risperidon-associated diabetes mellitus: A pharmacovigilance study. Pharmacotherapy, 23(6), 735–744. https://doi.org/10.1592/phco.23.6.735.32178
Lally, J., & MacCabe, J. H. (2015). Antipsychotic medication in schizophrenia: A review. British Medical Bulletin, 114(1), 169–179. https://doi.org/10.1093/bmb/ldv017
Lee, P. G., & Halter, J. B. (2017). The pathophysiology of hyperglycemia in older adults: Clinical considerations. Diabetes Care, 40(4), 444–452. https://doi.org/10.2337/dc16-1732
Lindenmayer, J. P., Nathan, A. M., & Smith, R. C. (2001). Hyperglycemia is associated with the use of atypical antipsychotics. The Journal of Clinical Psychiatry, 62(23), 30–38. https://www.psychiatrist.com/read-pdf/8374/
Mamat & Sudikno. (2010). Factors associated with HDL cholesterol levels (Analisis Data of The Indonesian Family Life Survey 2007/2008). Gizi Indonesia, 33(2), 143–149. https://doi.org/10.36457/gizindo.v33i2.90
Meyer, J. M., & Koro, C. E. (2004). The effects of antipsychotic therapy on serum lipids: A comprehensive Review. Schizophrenia Research, 70(1), 1–17. https://doi.org/10.1016/j.schres.2004.01.014
Ministry of Health Republic of Indonesia. (2019). Basic health research, Distribution of schizophrenia/psychosis prevalence in Indonesia. https://databoks.katadata.co.id/datapublish/2019/10/08/persebaran-prevalensi-skizofreniapsikosis-di-indonesia
Mordarska, K., & Godziejewska-Zawada, M. (2017). Diabetes in the elderly. Menopause Review, 16(2), 38. https://doi.org/10.5114/pm.2017.68589
Nyenwe, E. A., Odia, O. J., Ihekwaba, A. E., Ojule, A., & Babatunde, S. (2003). Type 2 diabetes in adult Nigerians: A study of its prevalence and risk factors in Port Harcourt, Nigeria. Diabetes Research and Clinical Practice, 62(3), 177–185. https://doi.org/10.1016/j.diabres.2003.07.002
Patel, K. R., Cherian, J., Gohil, K., & Atkinson, D. (2014). Schizophrenia: Overview and treatment options. Pharmacy and Therapeutics, 39(9), 638–645.
Riawan, H., Kristanto, C. S., & Ikawati, Z. (2022). Comparison of risperidone-based antipsychotic therapy regimens against extrapyramidal syndrome, cognitive function, and metabolic disorders in schizophrenia patients. Majalah Farmaseutik, 18(2). https://doi.org/10.22146/farmaseutik.v1i1.60346
Sefrina, F. (2016). The relationship between family support and social functioning in outpatient schizophrenia patients. Jurnal Ilmiah Psikologi Terapan, 4(2), 140-160.
Susanti, S., & Bistara, D. N. (2018). Relationship between eating patterns and blood sugar levels in diabetes mellitus sufferers. Jurnal Kesehatan Vokasional, 3(1), Article 1. https://doi.org/10.22146/jkesvo.34080
Usman, J., Rahman, D., & Sulaiman, N. (2020). Factors associated with the incident of diabetes mellitus in patients at RSUD Haji Makassar. Jurnal Komunitas Kesehatan Masyarakat, 2(1), 16–22.
Van Winkel, R., De Hert, M., Wampers, M., Van Eyck, D., Hanssens, L., Scheen, A., & Peuskens, J. (2008). Major changes in glucose metabolism, including new-onset diabetes, within three months after initiation of or switch to atypical antipsychotic medication in patients with schizophrenia and schizoaffective disorder. The Journal of Clinical Psychiatry, 69(3), 472–479. https://doi.org/10.4088/jcp.v69n0320v
Vázquez-Bourgon, J., Ortiz-García de la Foz, V., Gómez-Revuelta, M., Mayoral-van Son, J., Juncal-Ruiz, M., Garrido-Torres, N., & Crespo-Facorro, B. (2022). Aripiprazole and risperidone present comparable long-term metabolic profiles: Data from a pragmatic randomized controlled trial in drug-naïve first-episode psychosis. International Journal of Neuropsychopharmacology, 25(10), 795–806. https://doi.org/10.1093/ijnp/pyac033
WHO. (2022). Schizophrenia. https://www.who.int/news-room/fact-sheets/detail/schizophrenia