22.1 Can Pediatric Bipolar Disorder be Successfully Treated When Comorbid With Conduct Disorder? A Secondary Analysis of Six Clinical Trials of Second Generation Antipsychotics

The second generation antipsychotic agents, although exhibit superior safety profile, is associated with metabolic adverse effects including weight gain, diabetes mellitus and hyperlipidaemia. These adverse effects are not only the risk factors for cardiovascular disease and diabetes mellitus but may also impair patients adherence to treatment. However, different member of second generation antipsychotics differ in their extent of metabolic adverse effects. The aim of the study was to evaluate the association between olanzapine, risperidone or quetiapine treatment and body mass index, blood pressure, diabetes mellitus and hyperlipidaemia in patients with Schizophrenia and Bipolar Disorder. Forty-four cases of Schizophrenia and Bipolar Disorder diagnosed with DSM-IV criteria were selected according to inclusion and exclusion criteria. Body weight, body mass index and blood pressure were measured at baseline, at the end of 4th, 8th and 12th weeks of treatment. Blood samples were collected to measure blood glucose and serum lipid profile at baseline and at the end of 4th, 8th and 12th weeks in the study group receiving treatment (olanzapine 20-30 mg/day, risperidone 4-16 mg/day and quetiapine 300-800 mg/day) after overnight fasting. Therapeutic use of olanzapine and risperidone in Schizophrenia and Bipolar Disorder for a period of 4th, 8th and 12th weeks was associated with significant increase in body weight and body mass index. Quetiapine did not cause significant changes in body weight and body mass index after 4 and 8 weeks. However, after 12 weeks treatment, body mass index increased significantly. Olanzapine, risperidone and quetiapine increased the blood glucose level significantly after 8 and 12 weeks treatment. Olanzapine and risperidone elevated the serum cholesterol, triglyceride and low density lipoprotein levels significantly after 4, 8 and 12 weeks. But quetiapine showed no significant change in lipid profile. However, olanzapine and risperidone significantly increased triglyceride level after 8 and 12 weeks. Amongst three drugs, quetiapine treatment increased high density lipoprotein level. Our study revealed that quetiapine treatment is associated with less risk of dyslipidaemia.

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Second Generation Antipsychotics (SGAs) in Schizophrenic Patients and Bipolar Disorder: Correlation With Metabolic Syndrome (NCEP ATP III(a))

Global Journal of Health Science ◽

10.5539/gjhs.v11n1p28 ◽

2018 ◽

Vol 11 (1) ◽

pp. 28

Author(s):

Consuelo Roldan Menco ◽

Anderson Díaz-Pérez ◽

Zoraida Barrios Puerta

Keyword(s):

Metabolic Syndrome ◽

Bipolar Disorder ◽

Second Generation ◽

Mental Illnesses ◽

Abdominal Circumference ◽

High Density Lipoproteins ◽

P Value ◽

Antipsychotic Treatment ◽

The Metabolic Syndrome ◽

Second Generation Antipsychotics

INTRODUCTION: The Metabolic Syndrome is a set of diverse clinical situations such as diabetes mellitus, hypertension and dyslipidemia. Patients with mental illnesses such as schizophrenia or bipolar disorder have a higher mortality than the general population attributable in 60% to somatic diseases and metabolic syndrome, where second generation antipsychotics increase the risk of weight gain and insulin resistance. Objectives. Correlate the treatment with second generation antipsychotics (SGAs) as a possible predictor for Metabolic Syndrome according to the NCEP ATP III (a) classification. METHODS: Descriptive, cross-sectional correlational study. The sample was of 92 patients, applying an open and convenience sampling due to the mental state of the patients in order to determine their degree of acceptance to the study (Informed Assent) and consent to the legal guardian as the main inclusion criterion. For the analysis, the following variables were considered: blood pressure, weight, height, abdominal circumference, serum levels of triglycerides, glucose and high density lipoproteins. The SPSS 20.0 ® program was used logistic regression analysis with a p-value <0.05 and a confidence level of 95%. RESULTS: SGAs most used was clozapine (54.3%). The correlation analysis showed that sociodemographic aspects such as personal history, habits, physical activity and paraclinical and anthropometric records correlated with the possible diagnosis of metabolic syndrome (p <0.05), but not with SGAs (p> 0.05). ). CONCLUSION: No correlation was found between the presence of the metabolic syndrome and the type of antipsychotic treatment.

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COMPARING THE EFFECT OF SECOND-GENERATION ANTIPSYCHOTICS VERSUS SELECTIVE SEROTONIN REUPTAKE INHIBITORS IN REFRACTORY OBSESSIVE-COMPULSIVE DISORDER: A SYSTEMATIC REVIEW OF THE PAST, PRESENT, AND FUTURE CLINICAL TRIALS

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i1.14528 ◽

2016 ◽

Vol 10 (1) ◽

pp. 150

Author(s):

Mehdi Sayah ◽

Fakher Rahim

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Early Treatment ◽

Serotonin Reuptake ◽

Selective Serotonin Reuptake Inhibitors ◽

Second Generation ◽

Treatment Programs ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Second Generation Antipsychotics

ABSTRACTObjective: In this concise and systematic review, the trend of using major medication modalities prescribed for refractory obsessive-compulsivedisorder (OCD), including serotonin-specific reuptake inhibitors (SSRIs) and second-generation antipsychotics (SGAs) are discussed.Methods: We systematically searched PubMed and Cochrane Central Register of Controlled Trials (CENTRAL) systematically using Mesh terms. OCDis extremely disabling and associated with considerable depression and other serious psychiatric illnesses.Results: Through databases, we found 78 randomized clinical trials (RCTs), which included selective SSRI compared with routine drug therapy orplacebo. Out of these 78 studies, 62 studies were conducted on adult patients with OCD, comprising 7920 cases. While only 16 RCTs were performedon children and adolescents with OCD, including 1313 people. We found 24 clinical trial studies related to SGAs, of which were conducted on adultpatients with OCD, including 992 cases.Conclusion: As our data showed among the SSRIs, fluvoxamine has been particularly well studied and used in RCTs in both children and adolescents withOCD. According to the summary of our review, it will be better when therapists use SGAs in the early treatment programs of refractory OCD. Thus, consideringour reviewed, it seems that the first choice of early treatment programs of refractory OCD is fluvoxamine in combination with quetiapine or aripiprazole.Keywords: Obsessive-compulsive disorder, Refractory, Second-generation antipsychotic drugs, Selective serotonin reuptake inhibitors.

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