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Routine screening and rates of metabolic syndrome in patients treated with clozapine and long-acting injectable antipsychotic medications: a cross-sectional study

Published online by Cambridge University Press:  24 March 2020

A. Lydon ,
J. Vallely ,
A. Tummon ,
S. Maher ,
S. Sabri ,
J. McLoughlin ,
A. Liew ,
C. McDonald Open the ORCID record for C. McDonald [Opens in a new window]  and
B. Hallahan
A. Lydon*
Affiliation:
College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland Child and Adolescent Mental Health Services, Galway, Ireland
J. Vallely
Affiliation:
College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
A. Tummon
Affiliation:
Galway-Roscommon Mental Health Services, University Hospital Galway, Galway, Ireland
S. Maher
Affiliation:
College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland Galway-Roscommon Mental Health Services, University Hospital Galway, Galway, Ireland
S. Sabri
Affiliation:
College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
J. McLoughlin
Affiliation:
College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland Galway-Roscommon Mental Health Services, University Hospital Galway, Galway, Ireland
A. Liew
Affiliation:
College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland Department of Medicine, Galway University Hospital, Galway, Ireland Department of Medicine, Portiuncula University Hospital, Galway, Ireland
C. McDonald
Affiliation:
College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland Galway-Roscommon Mental Health Services, University Hospital Galway, Galway, Ireland
B. Hallahan
Affiliation:
College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland Galway-Roscommon Mental Health Services, University Hospital Galway, Galway, Ireland
*
*Address for correspondence: A. Lydon, Galway University Hospital, West Galway CAMHS, Ballard House, Bothar le Cheile, Westside, GalwayH91 CKA4, Ireland. (Email: alma.lydon@hse.ie)
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Abstract

Objectives

To examine the rate of monitoring of metabolic syndrome and actual rates of metabolic syndrome in two patient cohorts [clozapine treatment and long-acting injectable (LAI) antipsychotic] who are reviewed on an equally regular basis (1–4 weekly) for administration of treatment.

Methods

Clinical and laboratory data are examined on 119 patients treated with clozapine and 116 patients treated with LAI antipsychotic medications to determine the rates of metabolic syndrome and evidence of monitoring for metabolic syndrome in the previous 6 months. Individuals with insufficient data from these cohorts were invited to attend for metabolic screening to determine actual rates of metabolic syndrome in these two cohorts of patients.

Results

All metabolic parameters were monitored to a significantly greater extent in the clozapine cohort (>90%), compared to those treated with LAI antipsychotic medications (<50%) (blood pressure, weight, lipid and glucose levels; p < 0.001). Metabolic syndrome was present in 38.9% of those treated with clozapine compared to 31.1% of patients treated with LAI antipsychotic medications (X2 = 0.54, p = 0.46).

Conclusions

These findings suggest that a robust screening plan should be in place to monitor for metabolic syndrome in individuals treated with LAI antipsychotic medications. This screening should include measurement of body weight, waist circumference, fasting glucose, lipids and fasting insulin levels. Early recognition of abnormal metabolic parameters allows early intervention, therefore, improving long-term cardiovascular outcomes.

Keywords

ClozapineLAI antipsychoticsmetabolic syndromeroutine monitoring
Type
Original Research
Information
Irish Journal of Psychological Medicine , Volume 38 , Issue 1: Themed Issue: Physical Health in Mental Illness , March 2021 , pp. 40 - 48
Copyright
© College of Psychiatrists of Ireland 2020

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