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. 2022 Mar 21;22(1):210.
doi: 10.1186/s12888-022-03853-y.

Previous exposure to antipsychotic drug treatment is an effective predictor of metabolic disturbances experienced with current antipsychotic drug treatments

Ye Yang #  1 , Peng Xie #  1 , Yujun Long  1 , Jing Huang  1 , Jingmei Xiao  1 , Jingping Zhao  1 , Weihua Yue  2 , Renrong Wu  3
Affiliations

Previous exposure to antipsychotic drug treatment is an effective predictor of metabolic disturbances experienced with current antipsychotic drug treatments

Ye Yang et al. BMC Psychiatry. .

Abstract

Background: Antipsychotic drugs are associated with adverse events, but serious side effects are not frequent. This study aimed to ascertain whether previous exposure to antipsychotic treatment was associated with metabolic disturbances induced by current antipsychotic medication.

Methods: A total of 115 antipsychotic-naïve patients, 65 patients with previous exposure to low-metabolic-risk antipsychotics, and 88 patients with previous exposure to high-metabolic-risk antipsychotics were enrolled in our case-control study. All patients were administered olanzapine. Body weight, body mass index (BMI), biochemical indicators of blood glucose and lipids, the proportion of patients who gained more than 7% of their body weight at baseline, and the percentage of dyslipidemia were evaluated. All assessments were conducted at baseline and at 4 and 6 weeks after treatment.

Results: Olanzapine treatment resulted in a significant increase in body weight and BMI in antipsychotic-naïve patients compared with the other two groups (both p < 0.05). However, increases in lipid levels in the high-metabolic-risk antipsychotics group were significantly higher than that in the other two groups (both p < 0.05). A history of antipsychotics use was not associated with weight gain (all p > 0.05). Higher low-density lipoprotein cholesterol ≥3.37 mmol/L-1 was observed in antipsychotics exposure group compared with no history of antipsychotics exposure (aOR, 1.75; 95% CI, 1.07-3.52). Particularly, a history of high-metabolic-risk antipsychotics use was associated with a higher risk of LDL-C ≥3.37 mmol/L-1(aOR, 2.18; 95% CI, 1.03-3.32) compare with other two groups.

Conclusions: A history of exposure to antipsychotics, particularly high-metabolic-risk antipsychotics, is associated with current antipsychotic-induced metabolic disturbances.

Keywords: Antipsychotic; Metabolic side effects; Schizophrenia; Side effects; Weight.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Flowchart of participation in the study
Fig. 2
Fig. 2
Subgroup analysis of changes in body weight and metabolic parameters among different groups after 4 weeks of olanzapine treatment. a Changes in body weight and metabolic parameters among different groups with 1 to 2 years of previous antipsychotics exposure. b Changes in body weight and metabolic parameters among different groups with 2 to 5 years of previous antipsychotics exposure. c Changes in body weight and metabolic parameters among different groups with more than 5 years of previous antipsychotics exposure. A, B, and C represent the antipsychotic-naïve group, low-metabolic-risk antipsychotics group, and high-metabolic-risk antipsychotics group, respectively
Fig. 3
Fig. 3
Subgroup analysis of changes in body weight and metabolic parameters among different groups after 6 weeks of olanzapine treatment. a Changes in body weight and metabolic parameters among different groups with 1 to 2 years of previous antipsychotics exposure. b Changes in body weight and metabolic parameters among different groups with 2 to 5 years of previous antipsychotics exposure. c Changes in body weight and metabolic parameters among different groups with more than 5 years of previous antipsychotics exposure. A, B, and C represent the antipsychotic-naïve group, low-metabolic-risk antipsychotics group, and high-metabolic-risk antipsychotics group, respectively
Fig. 4
Fig. 4
Forest plot of the multivariate analyses for the risk of metabolic adverse reactions. a Adjusted odds ratios and two-sided 95% confidence intervals of weight gain of more than 7% of initial weight after previous antipsychotic treatment compared to no previous antipsychotic treatment in different metabolic risk subgroups. b Adjusted odds ratios and two-sided 95% confidence intervals of HDL-C <1.04 mmol/L–1 after previous antipsychotic treatment compared to no previous antipsychotic treatment in different metabolic risk subgroups. c Adjusted odds ratios and two-sided 95% confidence intervals of LDL-C ≥3.37 mmol/L–1 after previous antipsychotic treatment compared to no previous antipsychotic treatment in different metabolic risk subgroups. APs, history of exposure to antipsychotics; high-metabolic-risk APs, history of exposure to high-metabolic-risk antipsychotics; low-metabolic-risk APs, history of exposure to low-metabolic-risk antipsychotics
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