Metabolic Syndrome in Psychotic Disorder Patients Treated With Oral and Long-Acting Injected Antipsychotics

Background: Persons with severe mental illnesses have increased risks for metabolic syndrome and other metabolic disorders. Such risks may be greater among those diagnosed with schizoaffective disorder (SzAff) than with schizophrenia (Sz) and are strongly associated with long-term antipsychotic drug treatment. It remains unclear whether newer drugs, including long-acting injected long- acting (LAI) antipsychotics, may have lesser risks than other types. Methods: We recruited 151 chronic psychotic disorder subjects (89 Sz, 62 SzAff), and compared selected characteristics, including metabolic measures, by diagnosis and treatment with oral vs. LAI antipsychotics. Results: Factors associated more with SzAff than Sz ranked: mood-stabilizer treatment, women, higher total and LDL cholesterol, antidepressant treatment, higher body-weight, and more employment. Factors associated more with use of LAI than oral antipsychotics ranked: lower BPRS score, less mood-stabilizer treatment, lower LDL cholesterol, higher Hgb-A1c, lower CPZ-eq dose of antipsychotics, and shorter QTc interval. Conclusions: These findings add to evidence that SzAff patients may have higher risks of metabolic abnormalities than Sz subjects, perhaps related to the complexity of the SzAff syndrome and its treatment. However, LAI antipsychotics may help to limit such risks, with favorable effects on psychotic symptoms.