PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of bmcpsycBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Psychiatry
 
BMC Psychiatry. 2011; 11: 118.
Published online Jul 26, 2011. doi:  10.1186/1471-244X-11-118
PMCID: PMC3155482
Is antipsychotic polypharmacy associated with metabolic syndrome even after adjustment for lifestyle effects?: a cross-sectional study
Fuminari Misawa,corresponding author1 Keiko Shimizu,2 Yasuo Fujii,1 Ryouji Miyata,1 Fumio Koshiishi,1 Mihoko Kobayashi,1 Hirokazu Shida,1 Yoshiyo Oguchi,1 Yasuyuki Okumura,3 Hiroto Ito,3 Mami Kayama,4 and Haruo Kashima5
1Yamanashi Prefectural KITA Hospital, 3314-13 Kamijominamiwari, Asahi-machi, Nerasaki-shi, Yamanashi, Japan
2Faculty of Nursing, Yamanashi Prefectural University, 1-6-1 Ikeda, Koufu-shi, Yamanashi, Japan
3Department of Social Psychiatry, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-machi, Kodaira-shi, Tokyo, Japan
4Psychiatric & mental Health Nursing, St. Luke's College of Nursing, 10-1 Akasi-cho, Chuo-ku, Tokyo, Japan
5Department of Psychiatry, Neuropsychiatry, Keio University, School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
corresponding authorCorresponding author.
Fuminari Misawa: misawa-ahme/at/ych.pref.yamanashi.jp; Keiko Shimizu: shimizu/at/yamanashi-ken.ac.jp; Yasuo Fujii: fujii-pfg/at/ych.pref.yamanashi.jp; Ryouji Miyata: miyata-abpw/at/ych.pref.yamanashi.jp; Fumio Koshiishi: koshiishi-abck/at/ych.pref.yamanashi.jp; Mihoko Kobayashi: kobayashi-ajfn/at/ych.pref.yamanashi.jp; Hirokazu Shida: shida-ance/at/ych.pref.yamanashi.jp; Yoshiyo Oguchi: oguchi-akdr/at/ych.pref.yamanashi.jp; Yasuyuki Okumura: yokumura/at/ncnp.go.jp; Hiroto Ito: ItoHiroto/at/ncnp.go.jp; Mami Kayama: mkayama/at/slcn.ac.jp; Haruo Kashima: kashima/at/sc.itc.keio.ac.jp
Received August 1, 2010; Accepted July 26, 2011.
Abstract
Background
Although the validity and safety of antipsychotic polypharmacy remains unclear, it is commonplace in the treatment of schizophrenia. This study aimed to investigate the degree that antipsychotic polypharmacy contributed to metabolic syndrome in outpatients with schizophrenia, after adjustment for the effects of lifestyle.
Methods
A cross-sectional survey was carried out between April 2007 and October 2007 at Yamanashi Prefectural KITA hospital in Japan. 334 patients consented to this cross-sectional study. We measured the components consisting metabolic syndrome, and interviewed the participants about their lifestyle. We classified metabolic syndrome into four groups according to the severity of metabolic disturbance: the metabolic syndrome; the pre-metabolic syndrome; the visceral fat obesity; and the normal group. We used multinomial logistic regression models to assess the association of metabolic syndrome with antipsychotic polypharmacy, adjusting for lifestyle.
Results
Seventy-four (22.2%) patients were in the metabolic syndrome group, 61 (18.3%) patients were in the pre-metabolic syndrome group, and 41 (12.3%) patients were in visceral fat obesity group. Antipsychotic polypharmacy was present in 167 (50.0%) patients. In multinomial logistic regression analyses, antipsychotic polypharmacy was significantly associated with the pre-metabolic syndrome group (adjusted odds ratio [AOR], 2.348; 95% confidence interval [CI], 1.181-4.668), but not with the metabolic syndrome group (AOR, 1.269; 95%CI, 0.679-2.371).
Conclusions
These results suggest that antipsychotic polypharmacy, compared with monotherapy, may be independently associated with an increased risk of having pre-metabolic syndrome, even after adjusting for patients' lifestyle characteristics. As metabolic syndrome is associated with an increased risk of cardiovascular mortality, further studies are needed to clarify the validity and safety of antipsychotic polypharmacy.
Articles from BMC Psychiatry are provided here courtesy of
BioMed Central