Lappin JM, et al. - In a large sample of outpatients treated with clozapine, researchers comprehensively assessed cardio-metabolic risk factors and their management. Findings revealed very high rates of cardiovascular and metabolic risk factors in relation to Clozapine use. These risk factors were frequently under-treated. They recommended prioritizing management of both physical and mental health. Rationalization of polypharmacy was also emphasized.

Methods

• Researchers performed an observational cross-sectional study.
• They approached all clozapine users attending specialized clozapine monitoring outpatient clinics in three public hospitals in Sydney, Australia to participate over the one-year period 01/10/2015–30/09/2016.
• At face-to-face interview and through medical record review, they assessed cardio-metabolic risk factors including metabolic syndrome, risk for future development of diabetes, smoking, physical activity, nutrition, and prescribed medications.
• They assessed the proportion receiving appropriate management among patients who had cardio-metabolic risk factors.

Results

• Researchers recognized 451 registered clozapine clinic attenders; 92.2% of these completed questionnaires and anthropometric measurements.
• For metabolic syndrome, 58.3% met criteria.
• Overweight status or obesity was noted in 79.6%.
• Blood pressure meeting metabolic syndrome criteria was noted in 55.9%.
• Elevated fasting blood glucose and elevated blood triglycerides were noted in 46.6% and 55.2% of patients, respectively.
• They noted that 43.6% were current smokers.
• Recommended weekly physical activity levels were acieved by only 10%.
• High consumption of unhealthy food categories was also noticed.
• Observations indicated that 32.1% were on additional antipsychotics.
• Cardio-metabolic risk factors were untreated or under-treated in the majority of individuals.