Screening for metabolic syndrome in patients on antipsychotic medication - A cross-sectional study in a Pakistani sample
Butt, Bushra M.
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Metabolic syndrome includes a number of cardiovascular risk factors that increase morbidity and mortality. Studies have identified increase in incidence of metabolic syndrome in patients with severe mental illness. Atypical antipsychotic medications have been linked with increased risk of metabolic syndrome. Method: 50 consecutive patients who were on antipsychotic medication for 3 months or more were screened for metabolic syndrome using a brief questionnaire, measurement of waist circumference or Body Mass Index and blood pressure and a subsequent blood test for fasting glucose and lipid profile. The anonymised data was analysed and presence of metabolic syndrome was identified using the consensus criteria by WHO, International Diabetic Federation and US National Cholesterol Education Program Adult Treatment Panel III. Results: 96% of the study population were taking second generation antipsychotic medication and for more than 12 months. 30% of the patients were obese and had BMI above 30Kg/m2. 18% of the total sample had elevated BP at or above 135/85 mmHg. 16 % of the patients had elevated Fasting Plasma Glucose Levels above 100mg/dl. 62% of the patients had dyslipidemia. Although 62% of the study sample had at least one individual cardiovascular risk factor (elevated triglyceride level) and 30% had two risk factors (obesity and dyslipidemia), applying the consensus criteria for presence of metabolic syndrome and using cut-off of 3 out of 5 criteria, only 14% of the sample were categorised as having metabolic syndrome. Conclusion: Patients taking antipsychotic medication long-term are at significant risk of metabolic syndrome. A careful risk-benefit analysis should inform the initial choice of antipsychotic medication. Psychiatrists should educate patients about the illness as well as medication related side effects and promote healthy lifestyle practices. Patients should be screened at baseline and monitored at regular intervals throughout the treatment. © 2018 Lahore Medical And Dental College. All rights reserved.