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Objective: The aim of this naturalistic follow-up study is to investigate the metabolic syndrome (MetS) frequency according to ATP III A criteria and its natural course in the patients with schizophrenia and schizoaffective disorder treated with typical and atypical antipsychotics.
Method: This prospective naturalistic follow-up study enrolled the inpatients and outpatients between 18–65 years of age, diagnosed to have schizophrenia or schizoaffective disorder according to the DSM-IV classification, who had been receiving antipsychotics for at least 12 weeks. This study was supported by Pamukkale University Scientific research committee (project No: 2008 TPF 029).
Results: At the baseline, 50,80% of patients (n: 123) were on atypical antipsychotics medication as monotherapy, 7.90% (n=17) were on typical antipsychotics as monotherapy, 16,70% (n= 40) were on typical and atypical combinations and, 25,43% (n= 51) were on atypical combinations. During six months treatment changes were evident in 46 (23.58%) patients, in total. They were mostly (69.50%) the patients receiving different combinations of antipsychotics. A typical antipsychotic was added on the treatment of five patients receiving atypical antipsychotics as monotherapy at the baseline. In addition to their ongoing treatment, one patient had received ziprasidone and five patients had received aripiprazole. Aripiprazole treatment was ceased in two patients; they were still under antipsychotic treatment in combination. The total number of received antipsychotic and antipsychotic monotherapy or its combinations were not significantly related to baseline and follow-up MetS frequency. The frequency of MetS was not different across antipsychotic regiment groups (typical, atypical or their combinations) at the follow-up visit. However, the frequency of MetS was slightly lower in the patients receiving ziprasidone or ariprazole (either monotherapy (p=0.082) or its combination (p=0.063)) than that of other patients at the follow up evaluation. Patients using depot antipsychotics alone or combined with other antipsychotic gained more weight (p=0.041).
Conclusion: Metabolic syndrome is an important issue in schizophrenia treatment. Understanding solely and combination effects of antipsychotics might help us to find correct medications for our patients.