Metabolic Complications of Antipsychotic Treatment in Newly Diagnosed Psychotic and Mood Disorders: A Case-Control Study on Dyslipidemia and Hyperglycemia

Objective: This study aimed to investigate the association between statin use and metabolic disorders when prescribed either as adjunctive therapy to antipsychotics or as monotherapy in newly diagnosed individuals with schizophrenia and other psychiatric disorders involving mood disturbances or psychosis. Methods and Materials: A matched case–control analysis was conducted using electronic medical records and files from Jordan University Hospital, King Abdullah University Hospital, and the National Center for Mental Health. Eligible patients were 20–55 years old, diagnosed with schizophrenia, bipolar disorder, or affective psychosis, and treated continuously for 4–6 months with the same antipsychotic or statin. Individuals with pre-existing medical conditions affecting metabolism (e.g., diabetes, endocrine or renal disorders, cardiovascular disease) were excluded. For each case presenting metabolic symptoms (dyslipidemia or hyperglycemia), a control participant was selected, matched by age, sex, psychiatric diagnosis, and metabolic profile. Conditional logistic regression was applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for each medication. Findings: The analysis included 986 cases with metabolic syndrome and 1,678 matched controls. The use of olanzapine (OR = 4.42, 95% CI: 3.73–5.23) and risperidone (OR = 5.17, 95% CI: 4.15–6.44) was strongly associated with a higher risk of metabolic syndrome, whereas quetiapine posed a minimal risk. Aripiprazole significantly reduced risk (OR = 0.081, 95% CI: 0.04–0.16). Statins also demonstrated a protective effect (OR = 0.27, 95% CI: 0.18–0.40). Conclusion: Findings suggest that statins may mitigate metabolic side effects in patients undergoing antipsychotic therapy. Importantly, mood disorder patients receiving statins did not develop metabolic complications, highlighting their potential role in improving both psychiatric and metabolic outcomes.