ArticleSchizophrenia (Heidelberg, Germany)2026
Associations between second-generation antipsychotics and metabolic outcomes in patients with schizophrenia and metabolic abnormalities.
Article in Schizophrenia (Heidelberg, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Second-generation antipsychotics (SGAs) were found to have varying metabolic side-effects for patients with schizophrenia, while no studies have examined the associations between adding or switching low-risk SGAs and metabolic outcomes. This real-world observational study aimed to examine the association of adding or switching to low-risk SGAs with metabolic syndrome and metabolic abnormalities for patients with schizophrenia from 25 healthcare organizations across Zhejiang Province, China. Participants were dichotomized into the low-risk SGAs group and the high/intermediate SGAs group according to whether adding or switching to low-risk SGAs. A 1:1 propensity score matching (PSM) using a nearest-neighbor method was conducted to balance the baseline characteristics between groups. The mean [standard deviation (SD)] age of included patients was 50.0 (12.4) years, and 288 (37.7%) were women. The PSM yielded 223 matched pairs, with no between-group differences in baseline characteristics. Compared to the high/intermediate SGAs group, the low-risk SGAs group showed consistent decreases in the proportion of participants with metabolic syndrome [e.g., at 6 months: risk differences = 19.28%, 95% confidence interval (CI) = -28.19% to -10.38%; odds ratio = 0.47, 95% CI = 0.30 to 0.72] and the number of metabolic abnormalities [e.g., at 6 months: mean difference (MD) = -0.52, 95% CI = -0.75 to -0.29; relative risk = 0.79, 95% CI = 0.71 to 0.87]. The low-risk SGAs group presented significant improvement in metabolic parameters, including lower levels of weight, glucose and triglyceride (e.g., for triglycerise, (MD = -0.41 mmol/L, 95% CI = -0.61 to -0.21 mmol/L at 6 months), compared to the high/intermediate risk SGAs group. These assocaitions were more pronounced in those with no comorbid physical conditions, lower BMI, shorter duration and reporting smoking or drinking. Adding or switching to low-risk antipsychotics was associated with a decrease in metabolic outcomes, which can be considered as an appropriate secondary prevention strategy for patients with both schizophrenia and metabolic abnormalities.
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