Clozapine patients exhibit higher risk for metabolic syndrome

Patients taking clozapine for schizophrenia should be regularly monitored because of an increased risk for metabolic abnormalities, according to a study published in the American Journal of Psychiatry.

The comparison study examined the prevalence of metabolic syndrome in 2 groups: 93 outpatients with schizophrenia and schizoaffective disorder who had been taking clozapine for at least 6 months and a matched comparison group (n= 2,701) from the National Health and Nutrition Examination Survey (NHANES). Patients were matched by age (between 17 and 55 years), body mass index (BMI, of at least 19 kg/m² ), and race/ethnicity.

The prevalence of metabolic syndrome was significantly higher among 50 clozapine patients (53.8%) compared with 369 participants (20.7%) in the matched group. This represents "serious long-term health implications," researchers from the University of Rochester Medical Center stated.

The clozapine group demonstrated significant associations between the presence of metabolic syndrome and both age (P<.001) and BMI (P<.0001). A marginal association between metabolic syndrome and the duration of clozapine therapy (P=.06) also was recognized. No associations were observed between other medications, smoking, or other variables. Within the NHANES group, metabolic syndrome was associated with age (P<.0001), race/ethnicity (P<.02), family history (P<.0001), and BMI (P<.0001).

SOURCE Lamberti JS, Olson D, Crilly JF, et al. Prevalence of the metabolic syndrome among patients receiving clozapine. Am J Psychiatry. 2006;163:1273–1276.