With regard to antipsychotic induced metabolic syndrome, patients will be assessed for their overall response to modern antipsychotics such as clozapine, including side-effects; in particular, we will examine weight gain. Our overall hypothesis is that antipsychotic-induced metabolic syndrome is related to genetic variation in specific systems that are connected to both psychosis and the metabolic syndrome.
A growing body of disturbing evidence indicates that clozapine and olanzapine, as well as the newer antipsychotics as a class, are linked to a notably increased risk of weight gain and metabolic disturbances (McEvoy et al., 2005). The metabolic syndrome, a collection of risk factors for cardiovascular disease, including abdominal obesity, insulin resistance, hypertension, and dyslipidemia, occurs at high rates in schizophrenia (Meyer et al., 2005; Saari et al., 2005), and this is confirmed by our own work with those on clozapine at CAMH. This is particularly troublesome when put in the context of mortality data: individuals with schizophrenia have a relative mortality risk 2.25 times that of the general population (Joukamaa et al, 2006), and the bulk of this excess appears related to coronary heart disease.
Our goal is to recruit individuals with Schizophrenia who are treated with antipsychotics, in particular with clozapine, olanzapine, quetiapine and risperidone anytime during the course of their disorder. Ideally, we would recruit medication naïve patients at the beginning of their treatment and follow them at week 2, 6, and then at 3, 6, and 12 months. We will be asking for informed consent at the baseline visit for a one time blood draw and some repeated diagnostic measures at follow up visits. The baseline visit will last between 1 to 1 ½ hrs. Compensation for participation in this study is provided.
The results of this research may lead to personalized diagnostics and individualized treatment of schizophrenia and drug-induced co-morbidities. Furthermore we will use the genetic findings in an attempt to define new targets for discovery of novel medications that do not have serious side effects.
Information for Physicians: (PDF 191kB)
Information for Patients: (PDF 112kB)