Effects of Lithium and Valproate on Blood Sugar, Blood Lipids, and Body Weight in Bipolar Patients

• Main Authors: Hui-Hua Chang, 張惠華
• Other Authors: Po-See Chen
• Format: Others
• Language: en_US
• Published: 2007
• Online Access: http://ndltd.ncl.edu.tw/handle/69145154748529076541

碩士 === 國立成功大學 === 臨床藥學研究所 === 95 === Objective: This study is to evaluate the presence of the metabolic syndrome in a group of 117 outpatients with bipolar disorder treated with mood stabilizers in Taiwan. Method: This was a cross-sectional study. We collected data from follow-up participants at psychiatric outpatient clinics. We focused on the presence of the metabolic syndrome, as defined by the 2005 International Diabetes Foundation (IDF) criteria. Results: We found that 33.9% of the patients met the IDF 2005 criterion for the metabolic syndrome, that 61.0% of them met the criterion for abdominal obesity, 36.8% for hypertriglyceridemia, 53.0% for lower high-density lipoprotein cholesterol, 18.6% for hypertension or on hypertension medications, and 13.7% for high fasting glucose or received antidiabetic medications. Through logistic regression model in subgroup analysis of metabolic syndrome, we found that exposing to the second generation antipsychotics (SGAs) in the past 3 or 3-6 months was not regarded as a significant predictor factor. The odds ratio of the SGAs were 1.687 and 1.393, respectively. We found that monotherapy with mood stabilizer contributed to metabolic syndrome as equal as the SGAs, and that once patients were treated with combined lithium and valproate therapy, the odds ratio of metabolic syndrome was increased to 15.507 (p=0.054). Conclusion: This study indicates that the metabolic syndrome is highly prevalent in patients with bipolar disorder. Physicians should be aware that the treatment of bipolar disorder involves the risk-benefit balance for patients in terms of adverse effects such as metabolic abnormalities. Based on the finding of this study, we suggest that the practicing psychiatrists and primary care professionals need to monitor the parameters which are included in the metabolic syndrome to identify those patients with an increased risk for cardiovascular diseases.