Impact of Antipsychotic Medication on Metabolic Syndrome in Psychiatry

Introduction Antipsychotic medications, while essential for the management of psychiatric disorders, are associated with significant metabolic adverse effects that can compromise overall health. Among these, metabolic syndrome represents a major clinical concern due to its established link with increased cardiovascular morbidity and mortality . Objectives To determine the prevalence of metabolic syndrome among patients receiving antipsychotic treatment and to analyze the correlations between different classes of antipsychotics and the occurrence of this syndrome. Methods A cross-sectional observational study was conducted in the Psychiatry Department of Avicenne, El Razi Psychiatric Hospital in Tunis, from January 2025 to April 2025 . Clinically stable outpatients under long-term antipsychotic treatment were included. Data were collected using a standardized clinical record form, and current antipsychotic regimens were retrieved from patient medical files. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Statistical analyses were performed using IBM SPSS version 25 . Results Evaluation of metabolic syndrome prevalence according to the NCEP ATP III criteria revealed a high rate of metabolic comorbidities among patients treated with antipsychotics. Among the 31 patients included , 77.8% had a family history of type 2 diabetes mellitus , and 88.9% had a family history of hypertension , both being major risk factors for metabolic syndrome. Regarding treatment distribution, 22.2% of patients were receiving haloperidol , 14.8% fluphenazine decanoate , 22.2%risperidone , 37% olanzapine , 25.9% clozapine , and 96.3% quetiapine . Statistical analysis demonstrated a significant association between the occurrence of metabolic syndrome and exposure to olanzapine (p = 0.041) and clozapine (p = 0.03) , indicating a more pronounced disturbance of metabolic homeostasis with these agents. Conversely, no significant correlation was found with haloperidol, risperidone, or quetiapine . The absence of significance for these agents may be attributed to the heterogeneous distribution of treatments within the study sample. Conclusions This study highlights a significant association between exposure to certain atypical antipsychotics , particularly olanzapine and clozapine , and the development of metabolic syndrome . These findings emphasize the importance of systematic screening and early management of metabolic abnormalities to mitigate cardiometabolic complications associated with antipsychotic therapy. An individualized therapeutic approach , taking into account each patient’s metabolic risk profile , is essential to optimize the benefit–risk balance of antipsychotic medications and to improve long-term psychiatric care outcomes. Disclosure of Interest None Declared