Metabolic Disturbances Arising Out of Psychiatric Pharmacotherapies and the Importance of Dietetic Intervention in Its Treatment
Özet
Objective: The aim of this study was to compare alterations at body weight, composition and blood biochemistry in adult patients (age: 40.54+/-12.82 years) taking pharmacotherapy for their psychiatric disorders and adults (age: 38.61+/-12.70 years) who were not taking psychiatric treatments. Material and Method: A total of 128 (111 female, 17 male) patients in study group, and 347 (312 female, 35 male) who didn't have any endocrinologic-metabolic or psychiatric disorders and were not on any drug treatment in control group were evaluated. At the beginning, antropometric measuremnts, body composition analysis with a bioelectrical impedance analyzer and blood samples for some biochemical tests (Fasting blood glucose, insulin, HbA1C, triglyceride, total cholesterol, HDL, LDL blood counting, vitamin B12, folate, zinc, CRP, homocystein, cortisol,fibrinogen, TSH, uric acid levels) were taken for all patients. Results were analyzed statistically by using a computer program SPSS for Windows 10.0 with Mann Whitney U, pearson corelation, multipl regression analysis and Student t tests. Results: Mean treatment length with psychiatric drugs of the patients was 5.29+/-5.99 year, and mean weight gain at this period was 12.05+/-6.80 kg. Most of the patients have been taking more than one type of psychiatric drugs and their distrubition were 71.9% antidepressants, 31.3% anti-psychotics, 25.0% mood stabilyzers and 10.9% anxyolitics. Mean weight gain, body mass index (BMI), waist and hip circumferences, and body,fat percent of patients in study group were higher than in control group. Also while blood glucose, insulin, triglyceride, TSH,fibrinogen levels were statistically higher; total protein, albumin, zinc and folat levels were find statistically lower in study group. When all participants in both of the groups were divided as normal weight, owerweight and obese according to BA,11, it was found that while BMI increasing waist and hip circum-ferences, body fat percent, blood insulin, HbA1C levels increased but HDL levels decreased significantly. In study group, treatment period corelated positifly with body fat percent, blood insulin, TSH and homocystein levels; but corelated negatively with albumin level. Weight gain corelated positively with waist and hip circumfernces, body fat percent, blood insulin, trigliseride and TSH levels; but corelated negatively with folat level in patients taking psychiatric drugs. Conclusion: According to results of this study, it was shown that patients treated with psychiatric drugs are sensitive to metabolic and cardiovascular diseases along with obesity. So, it was though that patients who need psychiatric pharmacotherapies may have benefit if evaluated and treated by a team consisting endocrinologic, metabolic and nutritional specialists. A dietician knowledgeable and experienced in medical nutrition therapies on endocrine-metabolism and psychiatric disorders areas has an importantrole for collaborating with other related units.
