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Changes in Body Mass and Metabolic Profiles in Patients with First-Episode Schizophrenia Treated for 12 Months with A First-Generation Antipsychotic

Published online by Cambridge University Press:  15 April 2020

B. Chiliza ,
L. Asmal ,
P. Oosthuizen ,
E. van Niekerk ,
R. Erasmus ,
M. Kidd ,
A. Malhotra  and
R. Emsley
B. Chiliza*
Affiliation:
Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
L. Asmal
Affiliation:
Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
P. Oosthuizen
Affiliation:
Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
E. van Niekerk
Affiliation:
Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
R. Erasmus
Affiliation:
Division of Chemical Pathology, Faculty of Medicine and Health Sciences, Tygerberg, South Africa
M. Kidd
Affiliation:
Centre for Statistical Consultation, Stellenbosch University, Stellenbosch, South Africa
A. Malhotra
Affiliation:
Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, New York, USA
R. Emsley
Affiliation:
Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
*
*Corresponding author. Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, Cape Town, South Africa Tel.: +27 21 938 9227; fax: +27 21 938 9738. E-mail address:bonga@sun.ac.za (B. Chiliza).
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Abstract

Objectives:

To assess changes in body mass and metabolic profiles in patients with first-episode schizophrenia receiving standardised, assured treatment and to identify predictors and moderators of the effects.

Methods:

We investigated the changes in body mass, fasting blood glucose and lipids in 107 largely antipsychotic naïve, first-episode schizophrenia patients who were treated according to a standard algorithm with long-acting injectable flupenthixol decanoate over 12 months.

Results:

Eighty-three (78%) participants completed the 12 months of treatment, and 104 (97%) received 100% of the prescribed injections during their participation. There were significant increases in BMI (P < .0001), waist circumference (P = 0.0006) and triglycerides (P = 0.03) and decrease in HDL (P = 0.005), while systolic (P = 0.7) and diastolic blood pressure (P = 0.8), LDL (P = 0.1), cholesterol (P = 0.3), and glucose (P = 0.9) values did not change over time. The triglyceride: HDL ratio increased by 91%. Change in BMI was only correlated with change in triglycerides (P = .008). The only significant predictor of BMI increase was non-substance abuse (P = .002).

Conclusions:

The risks of weight gain and metabolic syndrome associated with antipsychotic treatment in first-episode schizophrenia are not restricted to second generation antipsychotics. This is a global problem, and developing communities may be particularly susceptible.

Keywords

First-episode schizophreniaFlupenthixolWeight gainMetabolic syndromeDeveloping countries
Type
Original article
Information
European Psychiatry , Volume 30 , Issue 2 , February 2015 , pp. 277 - 283
Copyright
Copyright © Elsevier Masson SAS 2014

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