The concomitant use of second-generation antipsychotics and long-term antiretroviral therapy may be associated with increased cardiovascular risk.

TitleThe concomitant use of second-generation antipsychotics and long-term antiretroviral therapy may be associated with increased cardiovascular risk.
Publication TypeJournal Article
Year of Publication2014
AuthorsFerrara, M, Umlauf, A, Sanders, C, Meyer, JM, McCutchan, JAllen, Duarte, N, Atkinson, JHampton, Grant, I, Ellis, RJ
Corporate AuthorsCHARTER Group
JournalPsychiatry Res
Volume218
Issue1-2
Pagination201-8
Date Published2014 Aug 15
ISSN1872-7123
KeywordsAdult, Anti-Retroviral Agents, Antipsychotic Agents, Body Mass Index, Cardiovascular Diseases, Cross-Sectional Studies, Female, HIV Infections, Humans, Male, Middle Aged, Psychotic Disorders, Retrospective Studies, Risk, Risk Factors
Abstract

To study the effect of concurrent use of second-generation antipsychotics (SGAs) on metabolic syndrome (MetS) components conferring increased cardiovascular risk in a sample of human immunodeficiency virus (HIV)-infected adults taking antiretroviral therapy (ART). A retrospective study of participants consecutively recruited at the UCSD HIV Neurobehavioral Research Program examined effects of combined ART and SGAs on body mass index (BMI), nonfasting serum lipids, diabetes mellitus (DM) incidence, and mean arterial pressure (MAP). Metabolic outcome variables and covariates were compared using t-tests, Chi-squared or Fisher's exact tests. Linear and logistic multivariable models explored metabolic outcomes for participants taking (SGA+) or not taking (SGA-) concomitant SGAs, after controlling for demographic and HIV disease- and ART-related covariates. Of 2229 HIV-infected participants, 12% (N=258) were treated with SGAs. In multivariable models adjusted for relevant covariates, the SGA+ group had significantly higher mean triglycerides, significantly higher odds of DM, significantly higher MAPs and marginally higher BMI. The use of SGAs in HIV-infected adults taking ART was independently associated with worse indicators of MetS and cardiovascular risk. Aggressive monitoring for the metabolic complications from concurrent SGA and ART is indicated in all patients receiving these medication combinations.

DOI10.1016/j.psychres.2014.04.015
Alternate JournalPsychiatry Res
PubMed ID24794030
PubMed Central IDPMC4082695
Grant ListN01MH22005 / MH / NIMH NIH HHS / United States
P30 MH062512 / MH / NIMH NIH HHS / United States