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See detailDifferential effects of olanzapine and risperidone on plasma adiponectin levels over time: Results from a 3-month prospective open-label study.
Wampers, M.; Hanssens, L.; van Winkel, R. et al

in European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology (2012), 22

Second-generation antipsychotics (SGA), especially clozapine and olanzapine, are associated with an increased metabolic risk. Recent research showed that plasma adiponectin levels, an adipocyte-derived ... [more ▼]

Second-generation antipsychotics (SGA), especially clozapine and olanzapine, are associated with an increased metabolic risk. Recent research showed that plasma adiponectin levels, an adipocyte-derived hormone that increases insulin sensitivity, vary in the same way in schizophrenic patients as in the general population according to gender, adiposity and metabolic syndrome (MetS). The aim of the present study was to investigate whether different SGAs differentially affect plasma adiponectin levels independent of body mass index (BMI) and MetS status. 113 patients with schizophrenia (65.5% males, 32.3years old) who were free of antipsychotic medication were enrolled in this open-label prospective single-center study and received either risperidone (n=54) or olanzapine (n=59). They were followed prospectively for 12weeks. Average daily dose was 4.4mg/day for risperidone and 17.4mg/day for olanzapine. Plasma adiponectin levels as well as fasting metabolic parameters were measured at baseline, 6weeks and 12weeks. The two groups had similar baseline demographic and metabolic characteristics. A significant increase in body weight was observed over time. This increase was significantly larger in the olanzapine group than in the risperidone group (+7.0kg versus +3.1kg, p<0.0002). Changes in fasting glucose and insulin levels and in HOMA-IR, an index of insulin resistance, were not significantly different in both treatment groups. MetS prevalence increased significantly more in the olanzapine group as compared to the risperidone groups where the prevalence did not change over time. We observed a significant (p=0.0015) treatment by time interaction showing an adiponectin increase in the risperidone-treated patients (from 10,154 to 11,124ng/ml) whereas adiponectin levels decreased in olanzapine treated patients (from 11,280 to 8988ng/ml). This effect was independent of BMI and the presence/absence of MetS. The differential effect of antipsychotic treatment (risperidone versus olanzapine) on plasma adiponectin levels over time, independent of changes in waist circumference and antipsychotic dosing, suggests a specific effect on adipose tissues, similar to what has been observed in animal models. The observed olanzapine-associated reduction in plasma adiponectin levels may at least partially contribute to the increased metabolic risk of olanzapine compared to risperidone. [less ▲]

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See detailLe cerveau au centre des regulations metaboliques: anomalies chez les patients schizophrenes traites par antipsychotiques atypiques.
Hanssens, L.; Scheen, André ULg; van Winkel, R. et al

in Revue Médicale de Liège (2008), 63(5-6), 417-23

Schizophrenia is associated with an increased risk of metabolic disorders such as diabetes, dyslipidaemia and the metabolic syndrome. The prevalence of type 2 diabetes in schizophrenic patients is at ... [more ▼]

Schizophrenia is associated with an increased risk of metabolic disorders such as diabetes, dyslipidaemia and the metabolic syndrome. The prevalence of type 2 diabetes in schizophrenic patients is at least twice that of the general population. Around 40 percent of patients meet criteria for the metabolic syndrome. Recently there is a growing concern on the metabolic side effects of treatment with second generation antipsychotics. According to various studies, including a prospective study performed in Flanders, treatment with clozapine and olanzapine has the highest metabolic risk, followed by quetiapine and risperidone. Amisulpride, ziprasidone and aripiprazole appear to have a low metabolic risk. Appropriate care, taking into account the possible improvement of the metabolic risks factors, is important to reduce morbidity and mortality in schizophrenic patients treated with antipsychotic medications. [less ▲]

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See detailA case series: Evaluation of the metabolic safety of aripiprazole
De Hert, M.; Hanssens, L.; van Winkel, R. et al

in Schizophrenia Bulletin (2007), 33(3), 823-830

Metabolic abnormalities occur frequently in patients treated with antipsychotics and are of growing concern to clinicians. This study sought to determine whether antipsychotic-associated metabolic ... [more ▼]

Metabolic abnormalities occur frequently in patients treated with antipsychotics and are of growing concern to clinicians. This study sought to determine whether antipsychotic-associated metabolic abnormalities identified through intensive monitoring can be reversed by switching to aripiprazole. Recent evidence suggests that aripiprazole may exhibit a favorable metabolic safety profile. The study population is a subset of a large (n > 500) ongoing prospective cohort. Thirty-one consecutive patients with schizophrenia who were started on aripiprazole were included in the study. All patients underwent an extensive metabolic evaluation, including an oral glucose tolerance test, at baseline, at 6 weeks, and at 3 months post switch. Metabolic abnormalities were defined as any of the following: new onset diabetes, impaired fasting glucose, impaired glucose tolerance, metabolic syndrome (MetS) according to various definitions, and dyslipidemia. After 3 months of treatment with aripiprazole (mean daily dose 16.3 mg), there was a significant decrease in body weight, body mass index, and waist circumference. There was a significant reduction in fasting glucose, fasting insulin, insulin resistance index, and serum lipids levels (cholesterol, triglycerides, low-density lipoprotein (LDL), LDL/HDL, Chol/HDL, and non-HDL cholesterol). There was also a significant reduction in prolactin levels. All 7 cases of recent onset diabetes were reversed at 3 months follow-up. The MetS was reversed in 50% of patients at 3 months follow-up. Our results support the reversibility of recent onset diabetes on antipsychotic medication when detected early and followed by a switch to aripiprazole. [less ▲]

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See detailAnomalies of tolerance in glucose in schizophrenic patients treated with antipsychotics of second generation: 3 months prospective comparative study
Scheen, André ULg; De Hert, M.; Hanssens, L. et al

in Diabetes & Metabolism (2007, March), 33(Sp. Iss. 1), 129

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See detailReversibility of antipsychotic treatment-related diabetes in patients with schizophrenia - A case series of switching to aripiprazole
De Hert, M.; Hanssens, L.; van Winkel, R. et al

in Diabetes Care (2006), 29(10), 2329-2330

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See detailScreening for metabolic abnormalities in patients with schizophrenia treated with antipsychotics: are we doing enough?
Van Winkel, R.; De Hert, M.; Van Eyck, D. et al

in European Neuropsychopharmacology (2006, September), 16(Suppl. 4), 398

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See detailEvaluation of the metabolic safety of aripiprazole
De Hert, M.; Van Eyck, D.; Hanssens, L. et al

in European Neuropsychopharmacology (2006, September), 16(Suppl. 4), 399

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See detailA cross-sectional study of adiponectin in patients with schizophrenia
Hanssens, L.; De Hert, M.; Van Eyck, D. et al

in European Neuropsychopharmacology (2006, September), 16(Suppl. 4), 430-431

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See detailStatin therapy among schizophrenia patients with dyslipidemia
Wampers, M.; De Hert, M.; Hanssens, L. et al

in Schizophrenia Research (2006, January), 81(Suppl. S), 141

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See detailEvaluation of the metabolic safety of aripiprazole
De Hert, M.; Van Eyck, D.; Hanssens, L. et al

in Schizophrenia Research (2006, January), 81(Suppl. S), 133

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See detailA cross-sectional study of adiponectin in patients with schizophrenia
Hanssens, L.; De Hert, M.; Van Eyck, D. et al

in Schizophrenia Research (2006, January), 81(Suppl. S), 135

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See detailEffects of aripiprazole on serum lipids, a comparison with patients started on statin
Hanssens, L.; De Hert, M.; Van Eyck, D. et al

in Schizophrenia Research (2006, January), 81(Suppl. S), 135

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See detailPharmacological Treatment of Ambulatory Schizophrenic Patients in Belgium
Hanssens, L.; De Hert, M.; Wampers, M. et al

in Clinical Practice and Epidemiology in Mental Health (2006), 2

BACKGROUND: the objective of this study was twofold:1) Describe the use of antipsychotic treatments in ambulatory patients suffering from schizophrenia in Belgium.2) Evaluate to which extend antipsychotic ... [more ▼]

BACKGROUND: the objective of this study was twofold:1) Describe the use of antipsychotic treatments in ambulatory patients suffering from schizophrenia in Belgium.2) Evaluate to which extend antipsychotic treatment prescribing patterns are in accordance with published treatment guidelines. METHOD: A cross-sectional survey was carried out in 16 Belgian hospitals selected from a sample of 67 hospitals. The hospitals were equally distributed between the north and south part of the country and were representative of Belgian practice. During 2 months, participating psychiatrists were asked to record the medication use as well as demographic parameters of all consecutive ambulatory patients seen at their consultation or attending a day-hospital. Data concerning 1000 ambulatory patients with schizophrenia or schizoaffective disorder were collected. RESULTS: In Belgium, the use of atypical antipsychotics is frequent (69%) in ambulatory patients with schizophrenia. In the overall sample, 73% receive only one antipsychotic drug. The majority of patients are treated with drugs of only one antipsychotic drug group, either first- typical (29.8%) or second-generation, atypical antipsychotics (53.2%). 15.8% of patients combine different types of antipsychotics. Antipsychotic dosing is adequate for the majority of patients but about one fifth receives a higher than recommended dose as per package inserts. Polypharmacy remains within reasonable limits. The use of concomitant medication varies according the antipsychotic treatment: patients who take second-generation antipsychotics only, receive the least additional drugs. CONCLUSION: Atypical antipsychotics appear to be the first line treatment for schizophrenic psychosis. Psychiatrists working with ambulatory patients are well aware of treatment guidelines and follow them quite adequately. [less ▲]

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See detailPrevalence of diabetes, metabolic syndrome and metabolic abnormalities in schizophrenia over the course of the illness: a cross-sectional study.
De Hert, M.; van Winkel, R.; Van Eyck, D. et al

in Clinical Practice and Epidemiology in Mental Health (2006), 2

BACKGROUND: Patients with schizophrenia are at high risk of developing metabolic abnormalities. METHOD: A prospective study focusing on metabolic disturbances in patients with schizophrenia, including an ... [more ▼]

BACKGROUND: Patients with schizophrenia are at high risk of developing metabolic abnormalities. METHOD: A prospective study focusing on metabolic disturbances in patients with schizophrenia, including an oral glucose tolerance test, is currently ongoing at our University Hospital and affiliate services. The prevalence of metabolic abnormalities at baseline was assessed in a cohort of 415 patients with schizophrenia. The sample was divided into 4 groups according to duration of illness: first-episode patients (<1.5 years), recent-onset patients (between 1.5 and 10 years), subchronic patients (between 10 and 20 years) and chronic patients (>20 years). RESULTS: Metabolic abnormalities were already present in first-episode patients, and considerably increased with increasing duration of illness. When compared to the general population matched for age and gender, much higher rates of the metabolic syndrome (MetS) and diabetes were observed for patients with schizophrenia. For MetS, the increase over time was similar to that of the general population. In contrast, the difference in the prevalence of diabetes in patients with schizophrenia and the general population dramatically and linearly increased from 1.6% in the 15-25 age-band to 19.2% in the 55-65 age-band. CONCLUSION: Thus, the current data suggest that on the one hand metabolic abnormalities are an inherent part of schizophrenic illness, as they are already present in first-episode patients. On the other hand, however, our results suggest a direct effect of the illness and/or antipsychotic medication on their occurrence. The data underscore the need for screening for metabolic abnormalities in patients diagnosed with schizophrenia, already starting from the onset of the illness. [less ▲]

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See detailSix-month incidence of diabetes among schizophrenic patients in Belgium
Hanssens, L.; De Hert, M.; Van Eyck, D. et al

in European Neuropsychopharmacology (2005, October), 15(Suppl. 3), 483

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See detailRapid diabetes onset and its reversal among patients treated with second generation antipsychotics
De Hert, M.; Van Eyck, D.; Hanssens, L. et al

in European Neuropsychopharmacology (2005, October), 15(Suppl. 3), 483-484

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See detailD-Hormone analog alfacalcidol: an update on its role in post-menopausal osteoporosis and rheumatoid arthritis management
Richy, F.; Deroisy, Rita ULg; Lecart, Marie-Paule ULg et al

in Aging Clinical & Experimental Research (2005), 17(2), 133-142

Alfacalcidol (1-alpha-hydroxyvitamin D is a non-endogenous analog of vitamin D which can bypass the renal and intestinal regulatory mechanisms that control the production of calcitriol (1,25 ... [more ▼]

Alfacalcidol (1-alpha-hydroxyvitamin D is a non-endogenous analog of vitamin D which can bypass the renal and intestinal regulatory mechanisms that control the production of calcitriol (1,25-hydroxyvitamin D-3, the active form of vitamin D, D-Hormone). Alfiacalcidol may be metabolized into calcitriol with a limited risk of hypercalcemia. Alfacalcidol and calcitriol have been evaluated in animal and human studies assessing their effects on bone mineral density and fracture rates. More recently, they have been shown to produce beneficial effects in muscle, immune system, and autoimmune diseases, including rheumatoid arthritis. This paper discusses the therapeutic efficacy of alfacalcidol in reports in which it has been proposed as an interesting alternative to vitamin D or calcitriol. Some recent findings about general metabolism and regulation of vitamin D and its analogs are discussed. The biological and clinical effects of alfacalcidol in post-menopausal osteoporosis are reviewed, followed by critical appraisal of its efficacy in preventing bone loss and falls in the elderly. The lost two sections discuss the role of Danalogs in regulating the immune system, with particular regard to rheumatoid arthritis. The main results of this review show that alfacalcidol may have a wider range of therapeutic applicability, beyond simply restricting it to patients in hemodialysis or peritoneal dialysis with high serum levels of intact PTH. (c) 2005, Editrice Kurtis. [less ▲]

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See detailD-hormone analog alfacalcidol: its role in postmenopausal osteoporosis and rheumatoid arthritis management
Richy, Florent; DEROISY, Rita ULg; LECART, Marie-Paule ULg et al

in Osteoporosis International (2005, March), 16(Suppl.3), 105-106

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See detailOral glucose tolerance tests in schizophrenic patients treated with antipsychotics
De Hert, Marc; Van Eyck, Dominique; Hermans, Gilberte ULg et al

in International Journal of Neuropsychopharmacology (2004, June), 7(Suppl. 1), 424

Objective. –A recent consensus conference has proposed guidelines for the monitoring for diabetes in patients with schizophrenia and also identifies the need of long-term prospective studies. Method. – A ... [more ▼]

Objective. –A recent consensus conference has proposed guidelines for the monitoring for diabetes in patients with schizophrenia and also identifies the need of long-term prospective studies. Method. – A large scale prospective study on metabolic risks of antipsychotic medication is currently ongoing. At baseline, patients get a full laboratory screening, ECG and an oral glucose tolerance test (OGTT). Baseline data on 100 non-diabetic patients at study inclusion and stable on medication for at least 6 months are presented. Results. – Glucose abnormalities are found in 22% of patients at baseline.A monitoring protocol based only on fasting glucose would not have detected 63.6% of these patients with classifiable glucose abnormalities in our sample. Fasting insulin and measures for insulin resistance have a high predictive value for abnormalities late in the OGTT. Conclusion. – Already at baseline, metabolic problems are frequently present in patients with schizophrenia treated with antipsychotics. Adding assessment of fasting insulin in a monitoring protocol improves detection of glucose abnormalities late in an OGTT. [less ▲]

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