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01.12.2018 | Research article | Ausgabe 1/2018 Open Access

BMC Psychiatry 1/2018

Antipsychotic polypharmacy and metabolic syndrome in schizophrenia: a review of systematic reviews

Zeitschrift:
BMC Psychiatry > Ausgabe 1/2018
Autoren:
Sharea Ijaz, Blanca Bolea, Simon Davies, Jelena Savović, Alison Richards, Sarah Sullivan, Paul Moran
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12888-018-1848-y) contains supplementary material, which is available to authorized users.
Sarah Sullivan and Paul Moran are joint senior authors.

Abstract

Background

There is conflicting evidence on the association between antipsychotic polypharmacy and metabolic syndrome in schizophrenia. We conducted a review of published systematic reviews to evaluate evidence on the association between metabolic syndrome (diabetes, hypertension, and hyperlipidaemia) and exposure to antipsychotic polypharmacy in schizophrenia.

Methods

We searched five electronic databases, complemented by reference screening, to find systematic reviews that investigated the association of antipsychotic polypharmacy in schizophrenia with hypertension, diabetes, or hyperlipidaemia. Selection of reviews, data extraction and review quality were conducted independently by two people and disagreements resolved by discussion. Results were synthesised narratively.

Results

We included 12 systematic reviews, which reported heterogeneous results, mostly with narrative syntheses and without pooled data. The evidence was rated as low quality. There was some indication of a possible protective effect of drug combinations including aripiprazole for diabetes and hyperlipidaemias, compared to other combinations and/or monotherapy. Only one review reported the association between APP and hypertension. The most frequently reported combinations of medication included clozapine, possibly representing a sample of patients with treatment resistant illness. No included review reported results separately by setting (primary or secondary care).

Conclusions

Further robust studies are needed to elucidate the possible protective effect of aripiprazole. Long-term prospective studies are required for accurate appraisal of diabetes risk, hypertension and hyperlipidaemia in patients exposed to antipsychotic polypharmacy.
Zusatzmaterial
Additional file 1: Medline search strategy. (DOC 66 kb)
12888_2018_1848_MOESM1_ESM.doc
Additional file 2: Tables of excluded and ongoing reviews. (DOCX 64 kb)
12888_2018_1848_MOESM2_ESM.docx
Additional file 3: Weight gain as reported in included reviews. (DOCX 15 kb)
12888_2018_1848_MOESM3_ESM.docx
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