EPA-0395 – Metabolic Alterations Associated with First and Second Generation Antipsychotics: an Twenty-years Open Study

Abstract

Introduction:

The use of atypical antipsychotics (SGAs) is hindered by the frequent occurrence of metabolic side effects, resulting in worsened quality of life and greater mortality as a result of increased risk factors for metabolic syndrome [2] [3] in schizophrenic patients compared with general population [1].

Objectives:

To establish the relationship between antipsychotic efficacy and side effects, especially the impact of various antipsychotics on metabolic parameters after 20-year treatment with atypical (SGAs) and typical antipsychotics (FGAs)

Aims:

To identify advantages and disvantages of SGAs in terms of quality of life, costs and benefits.

Methods:

Forty-five psychiatric inpatients diagnosed with schizophrenia or schizoaffective disorder (DSM-IV-TR diagnosis), treated with typical (haloperidol) and atypical (clozapine, risperidone, olanzapine, quetiapine, aripiprazole) antipyschotics, were studied retrospectively during 20 years. We use data at baseline, follow-up: 1, 5, 10, 20 years. Rating scales administered: CGI-I, SAPS, SANS, PANSS.

Results:

The results have underlined a statistically significant variations(p value <.05) of the lipidic and glicidic profile. We have also found a reduction of the recorded values at endpoint vs baseline in aripiprazole and haloperidol groups. The glicemic values, were not statistically different in quetiapine, aripiprazole, risperidone and haloperidol groups. No significant statistical variations were observed in complete blood count, electrocardiogram, liver enzymes blood pressure and body weight.

Conclusions:

The results confirm studies on efficacy and effectiveness of both SGAs and FGAs, and their influence on metabolic profile and other biological parameters. These data can represent a’real world’ study in patients observed during our daily out-patient practice.