Cardiovascular risk factors and metabolic syndrome in patients treated with long-acting injectables antipsychotics: a retrospective study

Int Clin Psychopharmacol. 2023 May 1;38(3):160-168. doi: 10.1097/YIC.0000000000000448. Epub 2022 Dec 16.

Abstract

The present cross-sectional, retrospective study aimed to assess the prevalence of cardiovascular disease (CVD) risk factors and metabolic syndrome in a sample of psychiatric patients treated with long-acting injectable antipsychotics (LAIs). The clinical charts of 120 patients, mainly diagnosed with schizophrenia (30.0%), schizoaffective disorder (15.0%), and bipolar disorder (13.3%) on LAIs therapy - initiated in the period from 2013 to 2019 and lasting at least one year - were retrospectively reviewed and related socio-demographic, clinical and laboratory variables were collected. The 70.8% of patients were treated with first-generation LAIs, and the remaining 29.2% with second-generation LAIs. The overall sample showed low compliance in performing the required exams and evaluations related to CVD risk factors. The prevalence of metabolic syndrome was 30.8%, and, considering specific CVD risk factors, 55% of the total sample reported abdominal obesity, 43.3% arterial hypertension, 41.7% low HDL-cholesterol, 25.8% hypertriglyceridemia, and 20.8% fasting hyperglycemia. Lastly, 6.7% showed prolonged corrected QT (QTc) interval at the ECG. Patients treated with LAIs should be regularly monitored for metabolic changes and CVD risk factors. Metabolic changes rapidly develop after initiating an antipsychotic therapy and these often involve parameters, that can be easily recorded in an outpatient setting (e.g. abdominal obesity and hypertension).

MeSH terms

  • Antipsychotic Agents* / adverse effects
  • Cardiovascular Diseases* / chemically induced
  • Cardiovascular Diseases* / drug therapy
  • Cardiovascular Diseases* / epidemiology
  • Cross-Sectional Studies
  • Delayed-Action Preparations / therapeutic use
  • Heart Disease Risk Factors
  • Humans
  • Hypertension* / drug therapy
  • Metabolic Syndrome* / chemically induced
  • Metabolic Syndrome* / drug therapy
  • Metabolic Syndrome* / epidemiology
  • Obesity, Abdominal / drug therapy
  • Retrospective Studies
  • Risk Factors

Substances

  • Antipsychotic Agents
  • Delayed-Action Preparations