Topics:

Metabolic Syndrome in Patients With Major Depressive Disorder Associated Risk Factors: Page 3 of 3

Metabolic Syndrome in Patients With Major Depressive Disorder Associated Risk Factors: Page 3 of 3

Several recent studies have explored the link between metabolic syndrome, stress, and the hypothalamic-pituitary-adrenal axis.9,19,20 Brown and colleagues21 concluded that elevated cortisol levels are strongly associated with depression and abdominal obesity (and somewhat with diabetes and hypertension), but not with hy­perlipidemia. Thus, among the many factors important in the etiology of metabolic syndrome there may be con­­sid­­erable variability in which metabolic measures are affected as well as variability in the mechanisms of action.

Summary
Future research may allow more precise delineation of risks and lead to more clinically useful risk profiles. The criteria for metabolic syndrome continue to evolve, and this debate may point to important areas for new research.3 For example, some metabolic measures may be more important than others in psychiatric patients, and some risks may be negated by appropriate treatment (eg, statins, antihypertensives) or by a change in psychotropics.

The concern about metabolic syndrome should not be limited to patients with a diagnosis of schizophrenia or to those treated with atypical antipsychotics. The presence of even one criterion for metabolic syndrome is of potential concern and may be an early warning signal that can prevent progression to the full syndrome.

Drugs Mentioned in This Article
Carbamazepine (Carbatrol, Tegretol, others)
Divalproex (Epival, Depakote)
Lithium (Eskalith, Lithane, Lithobid)

 

Pages

References

1. Lakka HM, Laaksonen DE, Lakka TA, et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA. 2002;288: 2709-2716.
2. Laaksonen DE, Lakka HM, Niskanen LK, et al. Metabolic syndrome and development of diabetes mellitus: application and validation of recently suggested definitions of the metabolic syndrome in a pro­spective cohort study. Am J Epidemiol. 2002;156: 1070-1077.
3. National Institutes of Health. Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Executive summary. http://www.nhlbi.nih.gov/guidelines/ cholesterol/atp3xsum.pdf. Published May 2001. Accessed November 19, 2008.
4. Grundy SM. Metabolic syndrome: a multiplex cardiovascular risk factor. J Clin Endocrinol Metab. 2007;92:399-404.
5. Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet. 2005;365:1415-1428.
6. Alberti KG, Zimmet P, Shaw J; IDF Epidemiology Task Force Consensus Group. The metabolic syndrome—a new worldwide definition. Lancet. 2005; 366:1059-1062.
7. Newcomer JW. Second-generation (atypical) antipsychotics and metabolic effects: a comprehensive literature review. CNS Drugs. 2005;19:1-93.
8. Thakore JH. Metabolic disturbance in first episode schizophrenia. Br J Psychiatry. 2004;47:S76-S79.
9. Raikkonen K, Matthews KA, Kuller LH. Depressive symptoms and stressful life events predict metabolic syndrome among middle-aged women: a comparison of World Health Organization, Adult Treatment Panel III, and International Diabetes Foundation definitions. Diabetes Care. 2007;30:872-877.
10. Goethe JW, Szarek BL, Caley CF. Metabolic abnormalities in psychiatric inpatients. Presented at: 160th Annual Meeting of the American Psychiatric Association; May 19-24, 2007; San Diego.
11. Centers for Disease Control and Prevention (CDC). National Center for Health Statistics (NCHS). Nation­-al Health and Nutrition Examination Survey Data. Updated September 11, 2008. http://www.cdc.gov/nchs /nhanes.htm. Accessed November 19, 2008.
12. Everson-Rose SA, Meyer PM, Powell LH, et al. Depressive symptoms, insulin resistance, and risk of diabetes in women at midlife. Diabetes Care. 2004;27: 2856-2862.
13. Herran A, Ramirez ML, Carrera M, et al. Panic disorder, treatment with selective serotonin reuptake inhibitors, and cholesterol levels. J Clin Psychopharm. 2006;26:538-540.
14. Raeder MB, Bjelland I, Emil Vollset S, et al. Obesity, dyslipidemia, and diabetes with selective serotonin reuptake inhibitors: the Hordaland Health Study. J Clin Psychiatry. 2006;67:1974-1982.
15. Kinder LS, Carnethon MR, Palaniappan LP, et al. Depression and the metabolic syndrome in young adults: findings from the Third National Health and Nutrition Examination Survey. Psychosom Med. 2004; 66:316-322.
 
Loading comments...

By clicking Accept, you agree to become a member of the UBM Medica Community.