The frequency of metabolic syndrome in psychiatric patients using antidepressant medications

Amaç: Antidepresan kullanan hastalarda metabolik sendrom (MS) varlığını araştıran çalışma sayısı kısıtlıdır. Bu çalışma ile polikliniğe başvuran ve çeşitli antidepresan kullanan psikiyatrik hastalarda MS ve ilişkili faktörlerin oranlarını araştırmak ve karşılaştırmak amaçlanmıştır. Yöntem: Çalışma fluoksetin, paroksetin, sertralin, citalopram, essitalopram, klomipramin, venlafaksin kullanan 18-60 yaş arası depresif ve anksiyete bozukluğuna sahip 70 hastadan oluşmuştur. Çalışma ölçütlerine uyan hastaların açlık kan şekerleri, kan trigliserit ve kolesterol düzeyleri, ortalama kan basıncı, vücut kitle indeksi, bel çevresi ve Ulusal Kolesterol Eğitim Programı - Erişkin Tedavi Paneli III'e göre (NCEP-III) MS oranları tespit edildi. Sonuç: NCEP-III'e göre tüm hastalardaki MS sıklığı %32,8 idi. En yüksek metabolik sendrom oranları klomipramin, paroksetin ve venlafaksin gruplarında saptandı. Fluoksetin grubu metabolik sendrom açısından en güvenli ilaç olarak saptandı. Tartışma: Klasik antidepresanlar metabolik senrom oranlarını artırmaktadır ve bu da psikiyatrik hastaların mortalite, morbidite ve yaşam kalitesini etkilemesi açısından oldukça önemlidir.Objective: There are limited studies investigating the metabolic syndrome (MS) in patients using antidepressants. This study examines and compares the prevalence of MS and related factors in psychiatric patients taking various antidepressants at an outpatient clinic. Methods: The study comprised a total of 70 patients using fluoxetine, paroxetine, sertralin, citalopram, essitalopram, clomipramine and venlafaxine aged 18- 60 years with depressive and anxiety disorder. MS rates of patients (according to National Cholesterol Education Program-Adult Treatment Panel III-(NCEP III)) who met the study criteria were obtained. Results: In our study metabolic syndrome frequency was 32.8% in total patient groups according to NCEP-III criteria. The higher metabolic syndrome frequency was found in drug groups such as clomipramine, paroxetine and venlafaxine groups. The safest drug for metabolic syndrome was fluoxetine as seen in its relevant group. Conclusion: Conventional antidepressants may cause metabolic syndrome which is important for mortality, morbidity and quality of life of psychiatric patients

PINEAL GLAND VOLUME IN SCHIZOPHRENIA AND MOOD DISORDERS

Background: The majority of patients with schizophrenia and mood disorders have disruptions in sleep and circadian rhythm. Melatonin, which is secreted by the human pineal gland, plays an important role in sleep and circadian rhythm. The aim of the present study was to evaluate and compare pineal gland volumes in patients with schizophrenia and mood disorders. Subjects and methods: We retrospectively evaluated the pineal gland volumes of 80 cases, including 16 cases of unipolar depression, 17 cases of bipolar disorder, 17 cases of schizophrenia, and 30 controls. The total pineal gland volume of all cases was measured via magnetic resonance images, and the total mean pineal volume of each group was compared. Results: The mean pineal volumes of patients with schizophrenia, bipolar disorder, unipolar depression, and the controls were 83.55±10.11 mm³, 93.62±11.00 mm³, 95.19±11.61 mm³ and 99.73±12.03 mm³, respectively. The mean pineal gland volume of the patients with schizophrenia was significantly smaller than those of the other groups. Conclusions: Our data show that patients with schizophrenia have smaller pineal gland volumes, and this deviation in pineal gland morphology is not seen in those with mood disorders. We hypothesize that volumetric changes in the pineal gland of patients with schizophrenia may be involved in the pathophysiology of this illness