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A longitudinal comparison of the metabolic characteristics of outpatients with first episode psychosis taking second generation antipsychotics : an interim analysis Whitney, Zachary

Abstract

Background. Second generation antipsychotics (SGAs) are used widely for the treatment of schizophrenia and other psychotic disorders. Despite the efficacy of these compounds, they have been associated with a number of adverse events such as weight gain and type II diabetes. Methods. In this study we have performed an interim analysis of a four-month long clinical trial to evaluate the effects of SGA drugs on weight gain in patients with first episode psychosis. A completer’s analysis was performed approximately mid-way through the trial. Anthropometric measures were collected at baseline and again at four months. Physical activity and eating patterns were measured through the international physical activity questionnaire (IPAQ) and three factor eating questionnaire (TFEQ). Secondary outcomes that were investigated include the effects on psychopathology using the positive and negative syndromes scale (PANSS) and the Calgary depression scale (CDS), effects on global functioning through the social and occupational functioning scale (SOFAS), quality of life as assessed by the short-form 36 (SF-36). Adherence to medication was assessed through the medication adherence rating scale (MARS). A simple t-test (p=<.05) was used to detect differences in anthropometric data, the PANSS, and the CDS. Repeated measures one-way analysis of variance (ANOVA) (p=<.05) was utilized for analysis of SF-36, TFEQ, IPAQ, and MARS. Findings. At baseline, patients taking antipsychotics weighed significantly more than the control group. Significant increases in waist circumference were observed in patients taking antipsychotics at four months. Significant differences in BMI and heart rate were detected between groups at four months. Significantly lower SF-36 summary scores were detected between groups with significant improvements in mental health summary scores in the antipsychotic group. CDS scores also improved significantly. Conclusion. At four months of treatment with SGAs, patients may show measurable changes in metabolic parameters that could eventually lead to metabolic syndrome.

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Attribution-NonCommercial-NoDerivs 2.5 Canada