Antipsychotics and the Link Between Metabolic Syndrome and Schizophrenia By Prof Bernhard Baune

Posted on: July 16, 2019
Last Updated: August 19, 2020

Prof Bernhard Baune, Ph.D, MD, MPH, FRANZCP, holds the Cato Chair and is Head of Psychiatry at the  University of Melbourne. In 2011, he was appointed as Chair of Psychiatry and Head of Discipline of Psychiatry at the University of Adelaide. Under his leadership, psychiatry research at the University of Adelaide gained international recognition for excellence in neuroimmunology and genomics of mental disorders, and for innovation in molecular and clinical underpinnings of personalized psychiatry. Prof Baune has authored or co-authored 204  peer-reviewed publications and 14 book chapters. 

Author Quotes  

The key question on effect size could be a whole talk in itself. Sometimes we say an effect size of 0.05 or 0.06 or 0.07 is clinically meaningful; however, in individual cognitive scores, a smaller effect size might have larger functional implications in patients, which is really important to note.

Lurasidone’s receptor profile helps to improve important cognitive domains.

In this study, in around 200  patients re-admitted to the hospital due to schizophrenia, it was shown that higher BMI levels (median 28.5 kg/m2) were an independent predictor for readmission. So, there is a very close relationship there.

Summary and slides  

Professor Baune moves on to describe the pharmacology of lurasidone and the potential role of the individual targets in mediating its anti-depressant vs. anti-psychotic effects. He describes in vivo studies in which lurasidone improves composite and individual cognitive test scores. 

He then introduces the second part of his talk, which relates to physical health comorbidities. He reiterates the increased attention paid to metabolic syndrome in recent years and discusses the risk factors for patients. The known metabolic adverse effects of common antipsychotic treatments are described, as are the risk profiles of these medications, and the pharmacological targets involved. Professor Baune highlights the importance of understanding the number of patients that need to be treated to cause harm. 

He talks in detail about a study in which olanzapine and quetiapine elicited negative effects on a variety of metabolic parameters. 

Finally, it is noted that higher BMI is an independent predictor of psychiatric remission. 

Take-home Points  

  • The pharmacology of lurasidone and other antipsychotics is important in determining their anti-psychotic vs. anti-depressant and other effects. 
  • There is an important correlation between metabolic syndrome and schizophrenia, and this is impacted by antipsychotic treatments. 
  • BMI is an important predictor of psychiatric remission. 

Quiz


Learn more

  1. Patient Selection and Holistic Treatment in Schizophrenia By Prof Bernhard Baune
  2. Management of Metabolic Risk Associated With Antipsychotics By Prof Bernhard Baune
  3. Antidepressants, Antipsychotics and Cognitive Remediation in Schizophrenia by Prof Bernhard Baune
  4. Management of Schizophrenia and Common Comorbidities by Prof Bernhard Baune