Evidence map›Paper›PMID 37622178›Full record

ArticleSchizophrenia bulletin2024

Antipsychotic Medication and Risk of Metabolic Disorders in People With Schizophrenia: A Longitudinal Study Using the UK Clinical Practice Research Datalink.

Emily Eyles, Ruta Margelyte, Hannah B Edwards, Paul A Moran, David S Kessler, Simon J C Davies, Blanca Bolea-Alamañac, Maria Theresa Redaniel, Sarah A Sullivan

Open access · hybridAbstract read
In one paragraph

Article in Schizophrenia bulletin, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.6field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Emily EylesThe National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.ORCID 0000-0002-2695-7172
Ruta MargelyteThe National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.ORCID 0000-0002-7914-8037
Hannah B EdwardsThe National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.ORCID 0000-0002-1885-4771
Paul A MoranPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0002-9257-8699
David S KesslerPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Simon J C DaviesPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0003-0095-5993
Blanca Bolea-AlamañacWomen's College Hospital and University of Toronto, Toronto, ON, Canada.ORCID 0000-0002-6308-2731
Maria Theresa RedanielThe National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.ORCID 0000-0002-0668-0874
Sarah A SullivanPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0002-1446-8478
University Hospitals Bristol NHS Foundation Trust · GBUniversity of Bristol · GBCentre for Addiction and Mental Health · CAUniversity of Toronto · CA

Funding

National Institute for Health Research Applied Research Collaboration West
6 · The paper itself

Abstract

background and hypothesisAntipsychotics are first-line drug treatments for schizophrenia. When antipsychotic monotherapy is ineffective, combining two antipsychotic drugs is common although treatment guidelines warn of possible increases in side effects. Risks of metabolic side effects with antipsychotic polypharmacy have not been fully investigated. This study examined associations between antipsychotic polypharmacy and risk of developing diabetes, hypertension, or hyperlipidemia in adults with schizophrenia, and impact of co-prescription of first- and second-generation antipsychotics. STUDY

designA population-based prospective cohort study was conducted in the United Kingdom using linked primary care, secondary care, mental health, and social deprivation datasets. Cox proportional hazards models with stabilizing weights were used to estimate risk of metabolic disorders among adults with schizophrenia, comparing patients on antipsychotic monotherapy vs polypharmacy, adjusting for demographic and clinical characteristics, and antipsychotic dose. STUDY

resultsMedian follow-up time across the three cohorts was approximately 14 months. 6.6% developed hypertension in the cohort assembled for this outcome, with polypharmacy conferring an increased risk compared to monotherapy, (adjusted Hazard Ratio = 3.16; P = .021). Patients exposed to exclusive first-generation antipsychotic polypharmacy had greater risk of hypertension compared to those exposed to combined first- and second-generation polypharmacy (adjusted HR 0.29, P = .039). No associations between polypharmacy and risk of diabetes or hyperlipidemia were found.

conclusionsAntipsychotic polypharmacy, particularly polypharmacy solely comprised of first-generation antipsychotics, increased the risk of hypertension. Future research employing larger samples, follow-up longer than the current median of 14 months, and more complex methodologies may further elucidate the association reported in this study.

Indexed as

Antipsychotic AgentsDiabetes MellitusHyperlipidemiasHypertensionMetabolic DiseasesSchizophreniaAdultHumansLongitudinal StudiesProspective StudiesAntipsychotic AgentsantipsychoticsCPRDdiabeteshyperlipidemiahypertensiontime-varying

Identifiers

PMID37622178
PMCPMC10919771
OpenAlexW4386154275

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.