TY - JOUR
T1 - Combination therapy as a potential risk factor for the development of type 2 diabetes in patients with schizophrenia
T2 - The GOMAP study
AU - Mamakou, Vasiliki
AU - Hackinger, Sophie
AU - Zengini, Eleni
AU - Tsompanaki, Evgenia
AU - Marouli, Eirini
AU - Serafetinidis, Ioannis
AU - Prins, Bram
AU - Karabela, Athina
AU - Glezou, Eirini
AU - Southam, Lorraine
AU - Rayner, Nigel W.
AU - Kuchenbaecker, Karoline
AU - Lamnissou, Klea
AU - Kontaxakis, Vassilis
AU - Dedoussis, George
AU - Gonidakis, Fragiskos
AU - Thanopoulou, Anastasia
AU - Tentolouris, Nikolaos
AU - Zeggini, Eleftheria
N1 - Publisher Copyright:
© 2018 The Author(s).
PY - 2018/8/2
Y1 - 2018/8/2
N2 - Background: Schizophrenia (SCZ) is associated with increased risk of type 2 diabetes (T2D). The potential diabetogenic effect of concomitant application of psychotropic treatment classes in patients with SCZ has not yet been evaluated. The overarching goal of the Genetic Overlap between Metabolic and Psychiatric disease (GOMAP) study is to assess the effect of pharmacological, anthropometric, lifestyle and clinical measurements, helping elucidate the mechanisms underlying the aetiology of T2D. Methods: The GOMAP case-control study (Genetic Overlap between Metabolic and Psychiatric disease) includes hospitalized patients with SCZ, some of whom have T2D. We enrolled 1653 patients with SCZ; 611 with T2D and 1042 patients without T2D. This is the first study of SCZ and T2D comorbidity at this scale in the Greek population. We retrieved detailed information on first- and second-generation antipsychotics (FGA, SGA), antidepressants and mood stabilizers, applied as monotherapy, 2-drug combination, or as 3- or more drug combination. We assessed the effects of psychotropic medication, body mass index, duration of schizophrenia, number of hospitalizations and physical activity on risk of T2D. Using logistic regression, we calculated crude and adjusted odds ratios (OR) to identify associations between demographic factors and the psychiatric medications. Results: Patients with SCZ on a combination of at least three different classes of psychiatric drugs had a higher risk of T2D [OR 1.81 (95% CI 1.22-2.69); p=0.003] compared to FGA alone therapy, after adjustment for age, BMI, sex, duration of SCZ and number of hospitalizations. We did not find evidence for an association of SGA use or the combination of drugs belonging to two different classes of psychiatric medications with increased risk of T2D [1.27 (0.84-1.93), p=0.259 and 0.98 (0.71-1.35), p=0.885, respectively] compared to FGA use. Conclusions: We find an increased risk of T2D in patients with SCZ who take a combination of at least three different psychotropic medication classes compared to patients whose medication consists only of one or two classes of drugs.
AB - Background: Schizophrenia (SCZ) is associated with increased risk of type 2 diabetes (T2D). The potential diabetogenic effect of concomitant application of psychotropic treatment classes in patients with SCZ has not yet been evaluated. The overarching goal of the Genetic Overlap between Metabolic and Psychiatric disease (GOMAP) study is to assess the effect of pharmacological, anthropometric, lifestyle and clinical measurements, helping elucidate the mechanisms underlying the aetiology of T2D. Methods: The GOMAP case-control study (Genetic Overlap between Metabolic and Psychiatric disease) includes hospitalized patients with SCZ, some of whom have T2D. We enrolled 1653 patients with SCZ; 611 with T2D and 1042 patients without T2D. This is the first study of SCZ and T2D comorbidity at this scale in the Greek population. We retrieved detailed information on first- and second-generation antipsychotics (FGA, SGA), antidepressants and mood stabilizers, applied as monotherapy, 2-drug combination, or as 3- or more drug combination. We assessed the effects of psychotropic medication, body mass index, duration of schizophrenia, number of hospitalizations and physical activity on risk of T2D. Using logistic regression, we calculated crude and adjusted odds ratios (OR) to identify associations between demographic factors and the psychiatric medications. Results: Patients with SCZ on a combination of at least three different classes of psychiatric drugs had a higher risk of T2D [OR 1.81 (95% CI 1.22-2.69); p=0.003] compared to FGA alone therapy, after adjustment for age, BMI, sex, duration of SCZ and number of hospitalizations. We did not find evidence for an association of SGA use or the combination of drugs belonging to two different classes of psychiatric medications with increased risk of T2D [1.27 (0.84-1.93), p=0.259 and 0.98 (0.71-1.35), p=0.885, respectively] compared to FGA use. Conclusions: We find an increased risk of T2D in patients with SCZ who take a combination of at least three different psychotropic medication classes compared to patients whose medication consists only of one or two classes of drugs.
KW - Antidepressants
KW - First generation antipsychotics
KW - Mood stabilizers
KW - Schizophrenia
KW - Second generation antipsychotics
KW - Type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85051021748&partnerID=8YFLogxK
U2 - 10.1186/s12888-018-1826-4
DO - 10.1186/s12888-018-1826-4
M3 - Article
C2 - 30071838
AN - SCOPUS:85051021748
SN - 1471-244X
VL - 18
JO - BMC Psychiatry
JF - BMC Psychiatry
IS - 1
M1 - 249
ER -
