Early changes of blood lipid levels during psychotropic drug treatment as predictors of long-term lipid changes and of new onset dyslipidemia.
- Delacrétaz A Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland.
- Vandenberghe F Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland.
- Gholam-Rezaee M Centre of Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland.
- Saigi Morgui N Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland.
- Glatard A Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland.
- Thonney J Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland.
- Solida-Tozzi A Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland.
- Kolly S Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland.
- Gallo SF Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland.
- Baumann P Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland.
- Berney S Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland.
- Zulauff SV Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland.
- Aubry JM Division of Psychiatric Specialties, University Hospital of Geneva, Geneva, Switzerland.
- Hasler R Division of Psychiatric Specialties, University Hospital of Geneva, Geneva, Switzerland.
- Ebbing K Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland.
- von Gunten A Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland.
- Conus P Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland.
- Eap CB Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland; School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland. Electronic address: chin.eap@chuv.ch.
- 2017-11-13
Published in:
- Journal of clinical lipidology. - 2018
Early lipid changes
Metabolic follow-up
New onset dyslipidemia
Predictors
Psychotropic drugs
Adult
Area Under Curve
Cholesterol, HDL
Cholesterol, LDL
Dyslipidemias
Female
Humans
Incidence
Kaplan-Meier Estimate
Logistic Models
Male
Mental Disorders
Middle Aged
Predictive Value of Tests
Psychotropic Drugs
ROC Curve
Triglycerides
Young Adult
English
BACKGROUND
Cardiovascular diseases and dyslipidemia represent a major health issue in psychiatry. Many psychotropic drugs can induce a rapid and substantial increase of blood lipid levels.
OBJECTIVE
This study aimed to determine the potential predictive power of an early change of blood lipid levels during psychotropic treatment on long-term change and on dyslipidemia development.
METHODS
Data were obtained from a prospective study including 181 psychiatric patients with metabolic parameters monitored during the first year of treatment and with adherence ascertained. Blood lipid levels (ie, total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], non-high-density lipoprotein cholesterol [non-HDL-C], and fasting triglycerides [TGs]) were measured at baseline and after 1, 3, and/or 12 months of treatment.
RESULTS
Receiver-operating characteristic analyses indicated that early (ie, after 1 month of psychotropic treatment) increases (≥5%) for TC, LDL-C, TG, and non-HDL-C and decrease (≥5%) for HDL-C were the best predictors for clinically relevant modifications of blood lipid levels after 3 months of treatment (≥30% TC, ≥40% LDL-C, ≥45% TG, ≥55% non-HDL-C increase, and ≥20% HDL-C decrease; sensitivity 70%-100%, specificity 53%-72%). Predictive powers of these models were confirmed by fitting longitudinal multivariate models in the same cohort (P ≤ .03) as well as in a replication cohort (n = 79; P ≤ .003). Survival models showed significantly higher incidences of new onset dyslipidemia (TC, LDL-C, and non-HDL-C hypercholesterolemia, HDL-C hypocholesterolemia, and hypertriglyceridemia) for patients with early changes of blood lipid levels compared to others (P ≤ .01).
CONCLUSION
Early modifications of blood lipid levels following prescription of psychotropic drugs inducing dyslipidemia should therefore raise questions on clinical strategies to control long-term dyslipidemia.
Cardiovascular diseases and dyslipidemia represent a major health issue in psychiatry. Many psychotropic drugs can induce a rapid and substantial increase of blood lipid levels.
OBJECTIVE
This study aimed to determine the potential predictive power of an early change of blood lipid levels during psychotropic treatment on long-term change and on dyslipidemia development.
METHODS
Data were obtained from a prospective study including 181 psychiatric patients with metabolic parameters monitored during the first year of treatment and with adherence ascertained. Blood lipid levels (ie, total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], non-high-density lipoprotein cholesterol [non-HDL-C], and fasting triglycerides [TGs]) were measured at baseline and after 1, 3, and/or 12 months of treatment.
RESULTS
Receiver-operating characteristic analyses indicated that early (ie, after 1 month of psychotropic treatment) increases (≥5%) for TC, LDL-C, TG, and non-HDL-C and decrease (≥5%) for HDL-C were the best predictors for clinically relevant modifications of blood lipid levels after 3 months of treatment (≥30% TC, ≥40% LDL-C, ≥45% TG, ≥55% non-HDL-C increase, and ≥20% HDL-C decrease; sensitivity 70%-100%, specificity 53%-72%). Predictive powers of these models were confirmed by fitting longitudinal multivariate models in the same cohort (P ≤ .03) as well as in a replication cohort (n = 79; P ≤ .003). Survival models showed significantly higher incidences of new onset dyslipidemia (TC, LDL-C, and non-HDL-C hypercholesterolemia, HDL-C hypocholesterolemia, and hypertriglyceridemia) for patients with early changes of blood lipid levels compared to others (P ≤ .01).
CONCLUSION
Early modifications of blood lipid levels following prescription of psychotropic drugs inducing dyslipidemia should therefore raise questions on clinical strategies to control long-term dyslipidemia.
- Language
-
- English
- Open access status
- hybrid
- Identifiers
-
- DOI 10.1016/j.jacl.2017.10.002
- PMID 29128242
- Persistent URL
- https://sonar.ch/global/documents/232578
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