Metabolic abnormalities in patients with chronic psychiatric disorders receiving long-term psychopharmacological treatment

Psychopharmacological treatment is often associated with increased appetite and food intake. Regarding the underlying pathophysiological mechanisms, mainly antihistaminergic effects and changes in immunological and neuroendocrine systems have been discussed. Most of the studies just focussed on short-term treatment, we herein present data from a cross-sectional study on 37 patients who live in a psychiatric department since years on stable psychopharmacological treatment. The patients were diagnosed to suffer from schizophrenia or schizoaffective disorders (n=24), bipolar disorders (n=8), affective disorders (n=2), and organic caused psychic disorders (n=3). With respect to metabolic parameters, 16% of the patients were overweight (BMI 25–29), and even 62% were obese (BMI ≥30). Lipid levels were increased in a considerable proportion of the patients (68% had cholesterol levels >5,17mmol/l and 27% triglyceride values >2,0g/l). Elevated blood glucose was apparent in 16% of the patients (fasting glucose value >6,1mmol/l) and HbA1c-levels were in a pathological range in 11% of the patients (HbA1c >6%). Furthermore, other metabolic parameters were measured (uric acid, GOT, GPT, γGT, TSH, T3, T4). These findings support the relevance of metabolic monitoring during long-term psychopharmacological treatment, more detailed analysis has to be done to identify certain risk factors.