정신분열병 환자에서 항정신병 약물과 공복혈당 및 총 콜레스테롤 이상

Antipsychotics and the Abnormality of Fasting Glucose, Total Cholesterol in Schizophrenia

Objective: The concerns about significant weight gain induced by antipsychotics have been recently increased. It raised an issue about the possible effect of antipsychotics on the glucose and lipid metabolism. To address this issue, we investigated the prevalence of abnormal glucose metabolism (impaired fasting glucose (110 ㎎/dl≤fasting glucose≤125 ㎎/dl) or diabetes (fasting glucose≥126 ㎎/dl) in patients taking antipsychotics and also compared the prevalence of abnormal glucose metabolism between typical and atypical antipsychotics. Methods: The subjects included 76 outpatients and 109 inpatients with schizophrenia by DSM-IV diagnostic criteria who had been taking antipsychotics regularly for at least 1 month. We measured fasting glucose, total cholesterol level after midnight NPO. Information about demographic and clinical characteristics of patients was gathered from interview with patients, family members, and the medical records. Results: 24 of 185 schizophrenia patients (13.0%) showed abnormal glucose metabolism. 6 of 47 patients taking olanzapine (12.8%) and 2 of 34 patients taking haloperidol (5.9%) showed abnormal glucose metabolism. The prevalence of abnormal glucose metabolism was higher with olanzapine than with haloperidol, although the difference did not reach statistical significance. However, patients with olanzapine showed higher fasting glucose level than those with haloperidol. There was no significant correlation between medication dose and fasting glucose, total cholesterol level. Conclusion: The prevalence of abnormal glucose metabolism was higher in patients with antipsychotics. Olanzapine was more likely to raise fasting blood glucose to higher level than haloperidol. (Korean J Psychopharmacol 2005;16(1):33-41)