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Metabolic Syndrome Seen in Schizophrenia Patients

By Paula Moyer

ATLANTA, GA -- May 27, 2005 -- Significantly more schizophrenic patients had the metabolic syndrome at baseline in a study comparing various antipsychotic therapies than a cross-section of the US population, according to findings presented here May 23^rd at the 158^th Annual Meeting of the American Psychiatric Association (APA).

CATIE (Clinical Antipsychotic Trials in Intervention Effectiveness), a study funded by the National Institute of Mental Health and coordinated by the University of North Carolina at Chapel Hill, studied both schizophrenia and Alzheimer's disease patients and, in schizophrenia, eventually compared the effects of various antipsychotic therapies.

"The findings yield important baseline data about an important medical issue," said Scott Stroup, MD, PhD, co-principal investigator for the schizophrenia trial. He presented the first findings regarding the baseline status of 1,500 patients in the schizophrenia trial. The researchers then took those patients for whom they had fasting blood levels and compared them with a matched sample from the National Health and Nutrition Examination Survey (NHANES).

According to Dr. Stroup, an associate professor of psychiatry at University of North Carolina, 36% of men entering the trial met the criteria for the metabolic syndrome, compared with 20% of the matched NHANES sample. Among the women in the trial, 52% had the metabolic syndrome, compared with 25% of the women in NHANES.

Similarly, the rate of diabetes was three times higher among men and eight times higher among women, compared with the matched samples in NHANES.

Based on an analysis of blood pressure, smoking, cholesterol, and diabetes, researchers found that the men in the trial had a 9.4% risk of developing cardiovascular disease over 10 years, compared with 7% of the comparison group for the men. Women in the CATIE trial had a 6.3% risk of developing cardiovascular disease, compared with 4.2% of NHANES-matched women.

Eventually the trial will compare the effectiveness of olanzapine, quetiapine, risperidone, ziprasidone, and perphenazine in the first phase, which will last up to 18 months for responders. In two additional phases, clozapine, fluphenazine, and decanoate will be added. The goal of the study is to determine effectiveness of the drugs in typical treatment circumstances, so that patients included those who were substance abusers and those with comorbid medical conditions, as long as those conditions were stable, unlike clinical trials that typically exclude such patients.

It was conducted at 57 sites around the country, in Veterans Affairs centers, hospitals, academic centers, and private practices. The trial began enrolling patients in 2001 and was completed in 2004. Results are now being analyzed. Publication of results is expected later this year.

However, the baseline data may already help to resolve the controversy about any role that antipsychotic therapy may play in schizophrenic patients' dysregulation, said David Goff, MD. "This study has confirmed our impression that people with schizophrenia are at considerably greater risk for metabolic syndrome," said Dr. Goff, director of the schizophrenia program at Massachusetts General Hospital in Boston, Massachusetts, United States, and one of the CATIE researchers.


[Presentation title: Clinical Effectiveness of Atypical Antipsychotic Therapy. Abstract 30B.]

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