The Metabolic Indices of Persons with First-Episode Schizophrenia on Antipsychotic Medications: A 12-Week Follow-up Study

A bstract Background: Metabolic changes are a major limitation to antipsychotic medications, especially the second-generation ones. However, longitudinal studies on neuroleptic-naïve persons with first-episode schizophrenia are sparse in Sub-Saharan Africa. Objective: To determine the effect of antipsychotic medications on the metabolic indices of patients with first-episode schizophrenia. Materials and Methods: This was a follow-up study involving 64 persons with first-episode schizophrenia who met the eligibility criteria. Diagnosis of schizophrenia was made using the mini international neuropsychiatric interview psychotic disorder module. Metabolic indices examined were lipid profile [i.e., total cholesterol (TC), triglycerides, low-density lipoprotein (LDL), and high-density lipoprotein (HDL)], fasting blood glucose (FBG), waist–hip ratio (WHR), and body mass index. Changes in the metabolic indices across the intervals of follow-up were analyzed using repeated-measures analysis of variance with post hoc comparison. Results: All the metabolic indices indicated a significant increase at each interval of follow-up ( P < 0.001), such as TC ( F = 174.63, P < 0.001), HDL ( F = 124.27, P < 0.001), LDL ( F = 63.09, P < 0.001), very low-density lipoprotein (VLDL) ( F = 71.37, P = 0.008), FBG ( F = 62.90, P < 0.001), and WHR ( F = 65.13, P < 0.001). Interestingly, scores in VLDL ( t = 2.40, P = 0.01) and WHR ( t = 2.64, P = 0.01) were significantly higher in participants using typical antipsychotics when compared with those using atypical antipsychotics. Conclusion: Antipsychotic medications significantly increase the risk of metabolic abnormalities in patients. Regular monitoring and a multidisciplinary approach to management are needed. Patients should be regularly monitored for weight gain, high glucose levels, and abnormal lipid profiles, especially in the initial months of treatment. Patient education on diet and lifestyle changes is crucial to address weight gain.