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| |  Atypical Antipsychotic Treatment Can Trigger Onset of Metabolic Disorders in Elderly Patients: Presented at AAGP By Carole VanSickle Ellis SAVANNAH, Ga -- March 7, 2010 -- Antipsychotic medications are increasingly being prescribed to elderly patients for a variety of psychiatric conditions, but doctors may need to rethink this strategy in light of metabolic complications. More than 50% of elderly patients with no history of dyslipidaemia or glucose intolerance eventually developed a metabolic disorder following treatment with an atypical antipsychotic, according to a study presented here on March 6 at the 2010 Annual Meeting of the American Association for Geriatric Psychiatry (AAGP). While atypical antipsychotics have been widely studied among younger age groups, the geriatric population appears to experience unique aspects of metabolic side effects from many of these medications. The research team, headed by Geneviève Létourneau, PhD, University of Montreal and the Louis-H Fontaine Hospital, Montreal, Quebec, followed 231 outpatients aged >=75 years being treated with risperidone, quetiapine, or olanzapine for psychosis, depression, bipolar disorder, or dementia. All had been treated with atypical antipsychotics for a minimum of 6 months over a 3-year period. The team monitored fasting glucose, lipid profiles, and biometric data including weight and abdominal circumference every 3 months for the first year of treatment, then every 6 months. The study excluded patients with dyslipidaemia or glucose intolerance. Time to onset of metabolic disorders was longer than reported in younger populations. Hyperglycaemia onset was shortest in patients treated with quetiapine (17.53 +- 17.34 mo) compared with olanzapine (32.69 +- 21.82 mo) or risperidone (36.30 +- 26.27 mo), but over time the prevalence of reports was the same. Time to onset of hypercholesterolaemia was also shortest among patients treated with quetiapine (15.86 +- 10.77 mo) than for the other 2 medications, with olanzapine at 27.42 (+-18.66) months and risperidone at 21.95 (+-19.73) months. Prevalence of hypercholesterolaemia was also highest among those treated with quetiapine. Quetiapine also appeared to be associated with the shortest time to onset and higher prevalence of hypertriglyceridaemia; time to onset was 20.96 months (+-12.66 mo) for quetiapine, 21.49 (+-18.62) months for olanzapine, and 25.03 (+-24.27) months for risperidone. “Our study results show that elderly patients exempt from metabolic disorders prior to treatment with quetiapine, olanzapine, and risperidone can develop hyperglycaemia, hypercholesterolaemia, or hypertriglyceridaemia, even after a considerable delay,” reported Dr. Létourneau. All 3 of the medications were associated with the onset of metabolic disorders, with >50% of patients showing some signs of metabolic disorders by the end of the study. Furthermore, the team noted that quetiapine was associated with earlier onset of metabolic disorders, but pointed out that these results could partially be due to a common physicians’ perception that this brand is “safer,” which could have led them to prescribe it more frequently to higher-risk patients. [Presentation title: Onset of Metabolic Disorders in Elderly Patients Treated With Atypical Antipsychotics. Abstract NR20]
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