Levels of Interleukin 6 as a Predictor of Metabolic Syndrome in Schizophrenic Patients Receiving Combination Therapy of Typical and Atypical Antipsychotics

Syamsuddin  Saidah; Lisal T.  Sonny; Haryani Lilik; Bahar  Burhanuddin; Rasyid  Haerani; Thioritz  Wempy

doi:10.3889/oamjms.2021.6378

Authors

Syamsuddin Saidah Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia
Lisal T. Sonny Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia
Haryani Lilik Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia
Bahar Burhanuddin Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia
Rasyid Haerani Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia
Thioritz Wempy Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2021.6378

Keywords:

Schizophrenia, Metabolic syndrome, Typical and atypical antipsychotics, IL-6

Abstract

BACKGROUND: Schizophrenia is a severe psychiatric disorder that causes disability and is often accompanied by physical illness. Based on the American Heart Association criteria, metabolic syndrome is common in schizophrenic patients, with a prevalence of 43% in Clinical Antipsychotic Trials of Intervention Effectiveness. The metabolic syndrome in patients with schizophrenia results from the side effects of antipsychotics. The metabolic syndrome will also show high levels of IL-6. This situation can have biological implications, which can then affect the health of schizophrenic patients.

AIM: This study aims to determine serum IL-6 levels as a predictor of metabolic syndrome in patients with metabolic syndrome due to side effects of using antipsychotic therapy.

METHODS: This prospective cohort study was not randomized, with the number of subjects was 28 schizophrenic patients who were evenly divided into two groups, namely, the group receiving atypical and typical combination therapy. Therapy was given to both groups for 3 months, and measurements and checks of bodyweight, abdominal circumference, blood pressure, BMI, TG, GDP, and Il-6 levels were carried out at baseline and 3rd month. Comparative and correlation tests were carried out between groups.

RESULTS: Some schizophrenic patients were categorized as metabolic syndrome and not a metabolic syndrome in both therapy groups (p < 0.020). However, atypical antipsychotic drug combinations are more likely to experience the metabolic syndrome. There was a change in the mean Il-6 levels at baseline and the 3rd month in both groups (p < 0.0001). There was a more excellent mean value of IL-6 levels at 3rd month with metabolic syndrome than those without metabolic syndrome. There was a greater mean value of IL-6 levels at third month with metabolic syndrome compared with those without metabolic syndrome in the haloperidol and chlorpromazine groups (p <0.005), the risperidone and clozapine groups (p <0.002).

CONCLUSION: Metabolic syndrome is more common in schizophrenic patients receiving atypical than typical combination therapy. The body’s response to the metabolic syndrome results in an increase in IL-6 levels due to an inflammatory process in visceral fat which accumulates due to weight gain due to the administration of antipsychotics. In schizophrenic patients with metabolic syndrome, IL-6 levels are higher than those without metabolic syndrome, so that IL-6 levels can be used as a predictor of metabolic syndrome in schizophrenic patients receiving antipsychotic therapy.

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