Metabolic side effects of antipsychotic agents: a prospective study in a teaching hospital.

Background: Antipsychotic drugs have propensity to produce side effects like extrapyramidal syndrome, hyperglycemia, lipid abnormalities and weight gain. As data from India related to this aspect are scarce, this study was carried out.Aims and Objectives: To study metabolic effects of antipsychotic drugs using biochemical parameters and to compare metabolic effects of different antipsychotic agents.Materials and methods: This was a prospective study of patients attending the psychiatry outpatient department from September 2007 to May 2008. Each patient enrolled was followed up for 12weeks or less till the antipsychotics were prescribed. Body weight,fasting blood glucose, fasting lipid profile were recorded at baseline and at subsequent visits.Results: Out of 45 patients, 33 completed the study. Bipolar disorder (31%) was the most frequent diagnosis followed by brief psychotic disorder (22%), schizophrenia (20%) and others.Olanzapine was the most frequently prescribed antipsychotic drug (56%) followed by risperidone (24%) and haloperidol (20%). 84% received single antipsychotic drug. After 12weeks of therapy all antipsychotics caused significant weight gain (p<0.001), olanzapine caused significant rise in fasting blood glucose (p<0.001) and serum cholesterol (p<0.001). All antipsychotics caused significant rise in serum triglyceride level (p<0.01) Conclusion: All antipsychotics can cause significant abnormalities in carbohydrate and lipid metabolism. Selection of antipsychotics, particularly the newer ones requires consideration of co morbidities like obesity, diabetes mellitus and dyslipidemias. During antipsychotic drug therapy periodic monitoring for metabolic abnormalities is advisable.