Antipsychotic drug linked to metabolic disorder

Treatment with clozapine, considered one of the most effective antipsychotic drugs, appears to increase the risk of developing metabolic syndrome, according to a report in the American Journal of Psychiatry.

Metabolic syndrome is a cluster of conditions that includes obesity, high triglyceride levels, high blood pressure and high blood sugar levels. People with the syndrome are at increased risk for heart attacks and stroke.

"Clozapine is the last hope for many people," lead author Dr. J. Steven Lamberti, from the University of Rochester Medical Center in New York, said in a statement. "But there are long-term health implications. This study suggests that patients who need the most effective medication are between a rock and a hard place."

The findings stem from a study of 93 outpatients who were receiving clozapine as a treatment for schizophrenia or schizoaffective disorder. The rate of metabolic syndrome in this group was compared with that seen in 2701 control subjects matched by age, body weight for height, and race or ethnicity.

Nearly 54 percent of clozapine-treated patients had metabolic syndrome compared with 20.7 percent of subjects in the comparison group. In addition to clozapine use, other risk factors for metabolic syndrome included older age and being overweight.

"We need to raise awareness of physicians about this issue so they monitor their patients and intervene promptly when required to prevent long-term adverse health consequences," Lamberti emphasized.

SOURCE: American Journal of Psychiatry

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Activity cuts death risk from artery disease

NEW YORK (Reuters Health) - Physical activity appears to reduce the risk of death in patients with peripheral artery disease (PAD), a serious life- and limb-threatening condition caused by plaque build-up in the arteries of the legs, according to findings in the journal Circulation.

Lower-extremity PAD affects approximately 8 million people in the United States. "Most PAD patients are inactive to avoid the pain of cramps in their legs," Dr. Mary M. McDermott, of Northwestern University, Chicago, Illinois, and colleagues note.

The researchers followed 460 patients with PAD, average age of 82 years, for 57 months. The patients were interviewed about their physical activity at enrollment, and the team used "accelerometers" to measure physical activity continuously over 7 days in 225 subjects. The researchers also adjusted their analysis to account for a number of factors that could affect the results.

Overall, 134 patients died during follow-up, including 75 of the group of patients who wore accelerometers.

Higher levels of physical activity were associated with a reduced risk of death. Patients with the lowest levels of activity were 3.5-times more likely to die than those with the highest levels. Similar results were seen regarding the risks of heart attack and stroke.

The benefit of interventions to increase physical activity would have to be tested in a clinical trial, the investigators say. "In the meantime, the present findings suggest that clinicians should encourage patients with PAD to increase their physical activity during daily life," they conclude.

SOURCE: Circulation

Copyright © 2006 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.