TY - JOUR
T1 - Lithium or valproate adjunctive therapy to second-generation antipsychotics and metabolic variables in patients with schizophrenia or schizoaffective disorder
AU - Vincenzi, Brenda
AU - Greene, Claire M.
AU - Ulloa, Melissa
AU - Parnarouskis, Lindsey
AU - Jackson, John W.
AU - Henderson, David C.
N1 - Publisher Copyright:
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2016
Y1 - 2016
N2 - Objective: People with schizophrenia are at greater risk for cardiovascular disease and their overallmortality rate is elevated compared to the general population. The metabolic side effects of antipsychotic medications have been widely studied; however, the effect of adding conventional mood stabilizers, such as lithium and valproate, to antipsychotic medication has not been assessed in terms of metabolic risk. The primary purpose of this secondary analysis was to examine whether treatment with lithium or valproate in addition to a second-generation antipsychotic is associated with poorer metabolic outcomes than treatment with a second-generation antipsychotic without lithium or depakote. Methods: Baseline data from 3 studies, which included measurement of body mass index, waist circumference, fasting glucose, insulin, homeostatic model assessment of insulin resistance, insulin sensitivity index, glucose utilization, and acute insulin response to glucose, were included in the analysis. Results: No differences were found between those taking lithium or valproate and those who were not in terms of fasting glucose, fasting insulin, and homeostatic model assessment of insulin resistance. Insulin sensitivity was lower among participants taking lithium or valproate. Participants taking lithium or valproate had a higher body mass index than those not taking conventional mood stabilizers, although the difference did not reach statistical significance. Conclusions: These cross-sectional findings suggest it may be beneficial to monitor insulin sensitivity and body mass index in patients taking lithium or valproate in combination with a second-generation antipsychotic.
AB - Objective: People with schizophrenia are at greater risk for cardiovascular disease and their overallmortality rate is elevated compared to the general population. The metabolic side effects of antipsychotic medications have been widely studied; however, the effect of adding conventional mood stabilizers, such as lithium and valproate, to antipsychotic medication has not been assessed in terms of metabolic risk. The primary purpose of this secondary analysis was to examine whether treatment with lithium or valproate in addition to a second-generation antipsychotic is associated with poorer metabolic outcomes than treatment with a second-generation antipsychotic without lithium or depakote. Methods: Baseline data from 3 studies, which included measurement of body mass index, waist circumference, fasting glucose, insulin, homeostatic model assessment of insulin resistance, insulin sensitivity index, glucose utilization, and acute insulin response to glucose, were included in the analysis. Results: No differences were found between those taking lithium or valproate and those who were not in terms of fasting glucose, fasting insulin, and homeostatic model assessment of insulin resistance. Insulin sensitivity was lower among participants taking lithium or valproate. Participants taking lithium or valproate had a higher body mass index than those not taking conventional mood stabilizers, although the difference did not reach statistical significance. Conclusions: These cross-sectional findings suggest it may be beneficial to monitor insulin sensitivity and body mass index in patients taking lithium or valproate in combination with a second-generation antipsychotic.
KW - Body mass index
KW - Conventional mood stabilizers
KW - Insulin sensitivity
KW - Lithium
KW - Metabolic side effects
KW - Schizophrenia
KW - Second-generation antipsychotics
KW - Valproate
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U2 - 10.1097/PRA.0000000000000149
DO - 10.1097/PRA.0000000000000149
M3 - Article
C2 - 27123797
AN - SCOPUS:84964847192
VL - 22
SP - 175
EP - 182
JO - Journal of Psychiatric Practice
JF - Journal of Psychiatric Practice
SN - 1527-4160
IS - 3
ER -