CONFERENCE PROCEEDING
Effects of long-term second generation antipsychotics use in liver and kindey function
 
More details
Hide details
1
Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, Thessaloniki, Greece
2
1st Department of Psychiatry, Sector of Neurosciences and Sensory Organs, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
3
Department of Forensic Psychiatry, Psychiatric Hospital of Thessaloniki, Thessaloniki, Greece
4
Psychiatric Clinic, General University Hospital of Larissa, Larissa, Greece
CORRESPONDING AUTHOR
Evangelia Papatriantafyllou   

Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, GR-57400, Sindos, Thessaloniki, Greece
Publication date: 2022-05-27
 
Public Health Toxicol 2022;2(Supplement 1):A100
 
KEYWORDS
ABSTRACT
Background:
Mentally disordered offenders provided with forensic psychiatric care are often treated with second generation antipsychotic medication (AP) and experience metabolic and inflammatory side effects. Disturbances in liver and kidney function are referred in literature, with main focus on those provoked by the first generation.

Aim:
The aim of the current investigation was to study the three-year fluctuation of selected liver and kidney function markers in forensic psychiatric patients receiving antipsychotic (AP) medication for more than five years, according to the type of ΑP.

Methods:
Thirty-five patients with psychotic disorders were classified into two groups based on the type of AP. Specifically: AP1, related to a lower risk, namely aripiprazole, amisulpride quetiapine XR, paliperidone, and ziprasidone, and AP2, related to an increased risk of weight gain and metabolic complications, namely olanzapine, asenapine, clozapine and risperidone. Medication and biochemical data relevant to liver and kidney function were retrieved from the individual medical files, specifically: urea, uric acid, creatinine, SGOT, SGPT, γ- GT, alkaline phosphotase, and amylase.

Results:
AP1 group of patients did not differ significantly in any biochemical substance over time. Both overall between the three time periods and in each pair of periods the patients of the AP1 group present approximately the same pattern to each biochemical feature.On the other hand, patients in the AP2 group differ significantly in uric acid (p = .015), SGOT (p = .018) and SGPT (p = .051) levels in at least one measurement compared to the others. Specifically, patients show significantly higher uric acid in the third time period than in the second (p = 0.014). It is worth noting that despite the apparent equality of creatinine values between the three time periods. It is observed that patients in the AP2 group showed significantly higher creatinine in the third time period compared to the second (p = 0.029). Furthermore, SGOT levels for this group (AP2) of patients are significantly higher in the second time period compared to the first (p = 0.038). Finally, patients show significantly lower levels of SGPT in the third time period compared to the second period (p = 0.024). In each case the values of the biochemical characteristics in each of the 3 time periods are reflected by the mean or median value calculated in each case.

Conclusions:
AP2 antipsychotics are more relevant to liver and kidney dysfunction. Therefore, the strategy behind choosing an antipsychotic drug should consider its hepatotoxicity and kidney damage, in addition to other complications, such as cardiovascular disease, obesity and metabolic syndrome.

 
REFERENCES (5)
1.
Aithal GP, Watkins PB, Andrade RJ, et al. Case definition and phenotype standardization in drug-induced liver injury. Clin Pharmacol Ther. 2011;89(6):806-815. doi:10.1038/clpt.2011.58
 
2.
Dumortier G, Cabaret W, Stamatiadis L, Saba G, Benadhira R, Rocamora JF, Aubriot-Delmas B, Glikman J, Januel D. Tolérance hépatique des antipsychotiques atypiques. Hepatic tolerance of atypical antipsychotic drugs. Article in French. Encephale. 2002;28(6):542-551. Accessed May 1, 2022. https://www.em-consulte.com/ar...
 
3.
Telles-Correia D, Barbosa A, Cortez-Pinto H, Campos C, Rocha NB, Machado S. Psychotropic drugs and liver disease: A critical review of pharmacokinetics and liver toxicity. World J Gastrointest Pharmacol Ther. 2017;8(1):26-38. doi:10.4292/wjgpt.v8.i1.26
 
4.
Todorović Vukotić N, Đorđević J, Pejić S, Đorđević N, Pajović SB. Antidepressants- and antipsychotics-induced hepatotoxicity. Arch Toxicol. 2021;95(3):767-789. doi:10.1007/s00204-020-02963-4
 
5.
Wu Chou AI, Lu ML, Shen WW. Hepatotoxicity induced by clozapine: a case report and review of literature. Neuropsychiatr Dis Treat. 2014;10:1585-1587. doi:10.2147/NDT.S67654
 
ISSN:2732-8929