Discuss Bipolar
Blog to discuss being Bipolar
Study results show a high prevalence of the metabolic syndrome in Taiwanese bipolar disorder (BD) patients, with metabolic abnormalities particularly common among patients co-treated with mood-stabilizers and second-generation antipsychotics (SGAs).
Although epidemiologic evidence in Western countries has shown increased metabolic disturbances in medicated BD patients, prevalence in Asian countries has not been widely reported.
To address this gap in knowledge, Po See Chen (National Cheng Kung University, Tainan, Taiwan) and colleagues conducted a cross-sectional study investigating the prevalence of the metabolic syndrome in 117 BD patients treated with lithium, valproate, or both.
The researchers found that 33.9% of patients met the International Diabetes Federation (IDF) 2005 criteria for the metabolic syndrome. Furthermore, 13.7%, 36.8%, 53.0%, 18.6%, and 61.0% of patients presented hyperglycemia, hypertriglyceridemia, low high-density lipoprotein (HDL) cholesterol, hypertension, and large waist circumference, respectively.
Compared with female patients, male patients had significantly lower HDL cholesterol (89.7 vs 101.6 mg/dl), higher systolic blood pressures (108.6 vs 117.8 mm Hg), and waist-to-hip ratios (0.86 vs 0.89).
As approximately 40% of the patients were co-treated with SGAs and one or both mood stabilizers, Chen and team examined the relationship between SGAs and metabolic abnormalities in the same cohort.
They found that co-treated BD patients had a significantly higher prevalence of metabolic abnormalities including hyperglycemia (18.0% vs 9.0%), higher triglycerides (42.0% vs 16.4%), and larger waist circumferences (69.7% vs 50.0%) than patients taking either lithium or valproate, or both, only.
“However, it remains unclear how mood stabilizer and SGAs collaborate together to cause higher prevalence of metabolic abnormalities,” write the researchers in the Journal of Affective Disorders.
Additionally, co-treated patients had a significantly longer duration of illness (5.9 vs 1.7 years) and were more likely to be diagnosed as BD I (86.0% vs 16.4%) compared with those not taking SGAs.
The team concludes: “In addition to balancing the benefits and adverse effects conferred by the medications, clinicians need to closely monitor the patient’s metabolic status.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009
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