Aurélie Delacrétaz1, Frederik Vandenberghe1, Mehdi Gholam-Rezaee2, Nuria Saigi Morgui1, Anaïs Glatard1, Jacques Thonney3, Alessandra Solida-Tozzi3, Stéphane Kolly3, Sylfa Fassassi Gallo3, Philipp Baumann3, Sylvie Berney3, Sandrine Valloton Zulauff3, Jean-Michel Aubry4, Roland Hasler4, Karsten Ebbing5, Armin von Gunten5, Philippe Conus3, Chin B Eap6. 1. Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland. 2. Centre of Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland. 3. Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland. 4. Division of Psychiatric Specialties, University Hospital of Geneva, Geneva, Switzerland. 5. Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland. 6. Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland; School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland. Electronic address: chin.eap@chuv.ch.
Abstract
BACKGROUND: Cardiovascular diseases and dyslipidemia represent a major health issue in psychiatry. Many psychotropic drugs can induce a rapid and substantial increase of blood lipid levels. OBJECTIVE: This study aimed to determine the potential predictive power of an early change of blood lipid levels during psychotropic treatment on long-term change and on dyslipidemia development. METHODS: Data were obtained from a prospective study including 181 psychiatric patients with metabolic parameters monitored during the first year of treatment and with adherence ascertained. Blood lipid levels (ie, total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], non-high-density lipoprotein cholesterol [non-HDL-C], and fasting triglycerides [TGs]) were measured at baseline and after 1, 3, and/or 12 months of treatment. RESULTS: Receiver-operating characteristic analyses indicated that early (ie, after 1 month of psychotropic treatment) increases (≥5%) for TC, LDL-C, TG, and non-HDL-C and decrease (≥5%) for HDL-C were the best predictors for clinically relevant modifications of blood lipid levels after 3 months of treatment (≥30% TC, ≥40% LDL-C, ≥45% TG, ≥55% non-HDL-C increase, and ≥20% HDL-C decrease; sensitivity 70%-100%, specificity 53%-72%). Predictive powers of these models were confirmed by fitting longitudinal multivariate models in the same cohort (P ≤ .03) as well as in a replication cohort (n = 79; P ≤ .003). Survival models showed significantly higher incidences of new onset dyslipidemia (TC, LDL-C, and non-HDL-C hypercholesterolemia, HDL-C hypocholesterolemia, and hypertriglyceridemia) for patients with early changes of blood lipid levels compared to others (P ≤ .01). CONCLUSION: Early modifications of blood lipid levels following prescription of psychotropic drugs inducing dyslipidemia should therefore raise questions on clinical strategies to control long-term dyslipidemia.
BACKGROUND:Cardiovascular diseases and dyslipidemia represent a major health issue in psychiatry. Many psychotropic drugs can induce a rapid and substantial increase of blood lipid levels. OBJECTIVE: This study aimed to determine the potential predictive power of an early change of blood lipid levels during psychotropic treatment on long-term change and on dyslipidemia development. METHODS: Data were obtained from a prospective study including 181 psychiatricpatients with metabolic parameters monitored during the first year of treatment and with adherence ascertained. Blood lipid levels (ie, total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], non-high-density lipoprotein cholesterol [non-HDL-C], and fasting triglycerides [TGs]) were measured at baseline and after 1, 3, and/or 12 months of treatment. RESULTS: Receiver-operating characteristic analyses indicated that early (ie, after 1 month of psychotropic treatment) increases (≥5%) for TC, LDL-C, TG, and non-HDL-C and decrease (≥5%) for HDL-C were the best predictors for clinically relevant modifications of blood lipid levels after 3 months of treatment (≥30% TC, ≥40% LDL-C, ≥45% TG, ≥55% non-HDL-C increase, and ≥20% HDL-C decrease; sensitivity 70%-100%, specificity 53%-72%). Predictive powers of these models were confirmed by fitting longitudinal multivariate models in the same cohort (P ≤ .03) as well as in a replication cohort (n = 79; P ≤ .003). Survival models showed significantly higher incidences of new onset dyslipidemia (TC, LDL-C, and non-HDL-C hypercholesterolemia, HDL-C hypocholesterolemia, and hypertriglyceridemia) for patients with early changes of blood lipid levels compared to others (P ≤ .01). CONCLUSION: Early modifications of blood lipid levels following prescription of psychotropic drugs inducing dyslipidemia should therefore raise questions on clinical strategies to control long-term dyslipidemia.
Authors: Aurélie Delacrétaz; Frederik Vandenberghe; Anaïs Glatard; Axel Levier; Céline Dubath; Nicolas Ansermot; Séverine Crettol; Mehdi Gholam-Rezaee; Idris Guessous; Murielle Bochud; Armin von Gunten; Philippe Conus; Chin B Eap Journal: Front Psychiatry Date: 2018-11-09 Impact factor: 4.157
Authors: Aurélie Delacrétaz; Anaïs Glatard; Céline Dubath; Mehdi Gholam-Rezaee; Jose Vicente Sanchez-Mut; Johannes Gräff; Armin von Gunten; Philippe Conus; Chin B Eap Journal: Clin Epigenetics Date: 2019-12-26 Impact factor: 6.551
Authors: Luis Alameda; Axel Levier; Mehdi Gholam-Rezaee; Philippe Golay; Frederik Vandenberghe; Aurélie Delacretaz; Philipp Baumann; Anaïs Glatard; Céline Dubath; Andres Herane-Vives; Victoria Rodriguez; Alessandra Solida; Kim Q Do; Chin B Eap; Philippe Conus Journal: PLoS One Date: 2020-12-03 Impact factor: 3.240
Authors: Marie Lenski; Jonathan Sidibé; Mehdi Gholam; Benjamin Hennart; Céline Dubath; Marc Augsburger; Armin von Gunten; Philippe Conus; Delphine Allorge; Aurelien Thomas; Chin B Eap Journal: Clin Transl Sci Date: 2021-08-20 Impact factor: 4.689