Beyond the "Hype" on the association between metabolic syndrome and atypical antipsychotics - The confounding effects of cohort, typical antipsychotics, severe mental illness, comedications, and comorbid substance use

Journal of Clinical Psychopharmacology (Impact Factor: 3.76). 05/2008; 28(2):125-31. DOI: 10.1097/JCP.0b013e318166f533
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    ABSTRACT: The author's work builds on D.G. Lowe's (1987) theory of perceptual groupings. Minimal processing is applied to an image to extract edges. The edges are then represented as well-defined two-dimensional patterns that the authors call interesting patterns. No attempt is made to infer three-dimensional structure from the patterns, and they are matched against two-dimensional models which are projections of characteristic views of three-dimensional objects. The patterns are built up from modular building blocks called triples
    Computer Vision, 1990. Proceedings, Third International Conference on; 01/1991
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    ABSTRACT: Leptin dysregulation has been implicated in the body weight gain and metabolic dysfunction observed with the second generation antipsychotic drugs (SGAD) olanzapine and clozapine. This study quantified the frequency of subjects with abnormal correlation between leptin and the body mass index controlling for gender (defined as being out of the upper or lower 95% confidence interval in the regression line when combining each group with the drug-free subjects) after prolonged treatment with olanzapine (n=126), clozapine (n=62), first generation antiypsychotics (n=91), other SGAD (n=22), other psychotropic drugs (n=65) and drug-free subjects (n=229). None of the analysis was significant (p>0.05). In fact, in 17 out of 20 comparisons, the drug-free group had numerically higher frequencies of outliers than the corresponding treatment group. There were 28 outliers (4.7% of the total sample). In agreement with previous studies, cross-sectional analysis did not report gross alterations in serum leptin levels during olanzapine or clozapine administration. Longitudinal studies should focus on leptin regulation early on treatment, on the frequency of abnormal leptin receptor sensitivity and/or specific polymorphisms in the leptin allele and on several confounding factors in order to design personalized preventive and therapeutic measures.
    Schizophrenia Research 10/2008; 106(2-3):315-9. DOI:10.1016/j.schres.2008.08.031 · 4.43 Impact Factor
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    ABSTRACT: In a previous study, we found an association between 5-hydroxytryptamine (serotonin) receptor 2C (HTR2C) polymorphisms and the occurrence of the metabolic syndrome in patients using antipsychotics. In the current study, we set out to replicate our findings in another sample of patients and to explore in a pooled analysis of both samples the influence of the effect of individual antipsychotics. Data for this cross-sectional study came from 2 different samples, the original sample (n = 112) and the replication sample (n = 164). Primary end point was the prevalence of the metabolic syndrome as classified by a modified version of the National Cholesterol Education Program's Adult Treatment Panel III. Primary determinants were polymorphisms in the promoter region of the HTR2C gene [HTR2C:c.1-142948(GT)n, rs3813929 (-759 C/T), and rs518147 (-697 G/C)] and an intragenic polymorphism (rs1414334:C>G). The variants of HTR2C:c.1-142948(GT)n (odds ratio [OR], 1.69; 95% confidence interval [CI], 0.75-3.81) and rs1414334 (OR, 2.35; 95% CI, 0.96-5.77) were not significantly associated with the metabolic syndrome in the replication sample but did show significance in the pooled analysis (OR, 2.09; 95% CI, 1.12-3.91; and OR, 2.35; 95% CI, 1.19-4.62, respectively). The variant rs1414334 C allele was specifically associated with the metabolic syndrome in patients using clozapine (OR, 9.20; 95% CI, 1.95-43.45) or risperidone (OR, 5.35; 95% CI, 1.26-22.83). This study extends previous findings to a larger sample of patients and implicates specific antipsychotic drugs. The increased risk for the metabolic syndrome is particularly strong in carriers of the rs1414334 C allele using clozapine or risperidone.
    Journal of clinical psychopharmacology 02/2009; 29(1):16-20. DOI:10.1097/JCP.0b013e3181934462 · 3.76 Impact Factor