정형항정신병 약물과 Risperidone 및 Clozapine의 장기투여에 의한 한국인의 당뇨병의 발생에 대한 후향적 비교조사 연구 = A Naturalistic Comparison Study of Typical Antipsychotics, Risperidone and Clozapine in Korean Schizaphrenic Patients with Diabetes Mellitus and weight Gain in Relation to Long-term Antipsychotic Treatment

다국어 초록 (Multilingual Abstract)

Background and Objectives: The goal of the study was to investigate the correlations, comparison, and prevalence of Korean diabetes mellitus with relation to various factors in schizophrenic patients treated with typical and atypical antipsychotics. Materials and Methods: Fasting blood glucose (FBS), 2-hour postprandial blood glucose (PP2), body mass index (BMI), and waist circumference were measured. To assess the clinical response to the medication, the clinical global impression scale was applied before and after antipsychotics treatment through the chart review. Cholesterol, triglyceride (TG), HDL cholesterol, LDL cholesterol, HbA1c, and serum level of prolactin were measured during the admission period. All laboratory findings were compared between typical and atypical antipsychotics groups. Results: 10.42% (25/240) of patients were diagnosed with type Ⅱ DM (9.55%, 15/157 males; 12.05%, 10/83 females). The diabetic prevalence of the typical antipsychotics group, the risperidone group, and the clozapine group were 40.00% (6/15), 61.53%, (8/13), and 0% (0/10), respectively (p=0.010). Among three drug groups, typical antipsychotics and risperidone groups not only developed weight gain and type Ⅱ DM, but also increased levels of cholesterol, TG and prolactin and waist circumference significantly statistically differed (p＜0.05) although the risperidone group showed the highest. However, the clozapine group did not develop type Ⅱ DM although it showed rapid weight gain (p=0.026). Conclusion: These results suggest that clozapine is less diabetogenic than typical antipsychotics and risperidone. Therefore, patients treated with long-term medicated antipsychotics should be monitored carefully.