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Selective serotonin reuptake inhibitors, anti-psychotics and metabolic risk factors in schizophrenia and bipolar disorder

Published online by Cambridge University Press:  23 March 2020

K.K. Fjukstad ,
A. Engum ,
S. Lydersen ,
I. Dieset ,
N.E. Steen ,
O. Andreassen  and
O. Spigset
K.K. Fjukstad
Affiliation:
Nord–Trøndelag Hospital Trust, Department of psychiatry, Levanger, Norway Norwegian University of Science and Technology, Department of Laboratory Medicine, Children's and Women's Health, Trondheim, Norway
A. Engum
Affiliation:
St. Olav University Hospital, Department of Psychiatry, Trondheim, Norway
S. Lydersen
Affiliation:
Norwegian University of Science and Technology, Regional Centre for Child and Youth Mental Health and Child Welfare, Trondheim, Norway
I. Dieset
Affiliation:
University of Oslo, Norment, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway
N.E. Steen
Affiliation:
University of Oslo, Norment, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway Vestre Viken Hospital Trust, Drammen District Psychiatric Center, Clinic of Mental Health and Addiction, Drammen, Norway
O. Andreassen
Affiliation:
University of Oslo, Norment, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway
O. Spigset
Affiliation:
Norwegian University of Science and Technology, Department of Laboratory Medicine, Children's and Women's Health, Trondheim, Norway St. Olav University Hospital, Department of Clinical Pharmacology, Trondheim, Norway

Abstract

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Objective

The aim of this study was to investigate the relationship between metabolic factors and use of selective serotonin reuptake inhibitors (SSRIs) combined with olanzapine, quetiapine or risperidone.

Method

Data from a cross-sectional study on 1301 patients with schizophrenia or bipolar disorder were analyzed. The main outcome variables were levels of total cholesterol, low – and high-density lipoprotein (LDL and HDL) cholesterol, triglycerides and glucose.

Results

One defined daily dose (DDD) per day of an SSRI in addition to olanzapine was associated with an increase in total cholesterol of 0.16 (CI: 0.01 to 0.32) mmol/L (P = 0.042) and an increase in LDL–cholesterol of 0.17 (CI: 0.02 to 0.31) mmol/L (P = 0.022). An SSRI serum concentration in the middle of the reference interval in addition to quetiapine was associated with an increase in total cholesterol of 0.39 (CI: 0.10 to 0.68) mmol/L (P = 0.011) and an increase in LDL-cholesterol of 0.29 (0.02 to 0.56) mmol/L (P = 0.037). When combined with risperidone, no such effects were revealed. No clear-cut effects were seen for HDL-cholesterol, triglycerides and glucose.

Conclusion

The findings indicate only minor deteriorations of metabolic variables associated with treatment with an SSRI in addition to olanzapine and quetiapine, but not risperidone. These results provide new insight in the cardiovascular risk profile associated with concomitant drug treatment in patients with severe mental illness, and suggest that SSRIs can be combined with anti-psychotics without a clinically significant increase of adverse metabolic effects.

Disclosure of interest

Co-author Dr. Ole Andreassen has received speakers’ honoraria from GSK, Lundbeck and Otsuka.

Type
e-Poster Viewing: Psychopharmacology and pharmacoeconomics
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S752
Copyright
Copyright © European Psychiatric Association 2017
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