Objective: To determine the association of metabolic syndrome with atypical antipsychotic drug (olanzapine) short term versus long term use.
Study Design: Case control study.
Place and Duration of Study: Chemical pathology department Army Medical College Rawalpindi, from Nov 2014 to Oct 2015.
Material and Methods: The study was carried out on 240 subjects, 120 cases and 120 controls. For the purpose of the study cases were divided into four groups A, B, C and D according to the duration of drug use. Group A patients included those who the last the drug olanzapine for the last three months. Group B patients included those who were using the drug olanzapine for the last six months. Group C and D included those who were using the drug for last 1 year and more than one year (2-5 years) respectively. By employing non probability convenience sampling technique the data was collected from patients having the diagnosis of psychosis as per DSM IV modified criteria through a proforma and fasting blood samples were drawn. These samples were tested for fasting serum lipid profile and fasting plasma glucose. The data obtained were analyzed using SPSS version 21. For quantitative data Mean and SD were calculated. For qualitative data frequency and percentages were calculated. Qualitative data was compared using chi square test whereas quantitative data was compared using independent sample t-test.
Results: There was statistically no significant difference in fasting plasma glucose between group A and B and their controls whereas in group C and D these levels were significantly high as compared to controls. Triglyceride levels were significantly higher and HDL cholesterol levels were significantly lower in all four groups as compared to controls. Comparison of qualitative data which included waist circumference and blood pressure showed statistically no significant rise for group A whereas waist circumference showed insignificant rise and blood pressure showed statistically significant rise for group B. On the other hand both waist circumference and blood pressure were significantly higher for group C and D as compared to controls. Overall study revealed a graded increase in components of metabolic syndrome with duration of olanzapine use. Out of thirty patients in each group two patients in group A, 5 in group B, 7 in group C and 10 patients in group D developed metabolic syndrome as per NCEP ATP III modified criteria.
Conclusion: Development of metabolic syndrome is strongly associated with long term use of atypical antipsychotic drug olanzapine.
Keywords : Atypical antipsychotic, Diabetes mellitus, Dyslipidemia, Metabolic syndrome, Olanzapine.