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No. 2 (2026)

ORIRGINAL RESEARCH

Dynamics of metabolic indicators in patients with schizophrenia during therapy with second- and third-generation antipsychotics

https://doi.org/10.48612/psyph/v6rv-t85a-ukg6

Published 2026-06-30

  • E.G. Kornetova
    • ,
  • S.A. Galkin
    • ,
  • A.N. Kornetov
    • ,
  • D.A. Petkun
    • ,
  • I.A. Mednova
    • ,
  • N.A. Bokhan

E.G. Kornetova
Mental Health Research Institute; Tomsk National Research Medical Center

S.A. Galkin
Mental Health Research Institute; Tomsk National Research Medical Center

A.N. Kornetov
Mental Health Research Institute; Tomsk National Research Medical Center; Kemerovo State Medical University

D.A. Petkun
Mental Health Research Institute; Tomsk National Research Medical Center

I.A. Mednova
Mental Health Research Institute; Tomsk National Research Medical Center

N.A. Bokhan
Mental Health Research Institute; Tomsk National Research Medical Center

Abstract

Relevance. Studies show that a number of widely used second-generation antipsychotics are associated with a high risk of metabolic disturbances. Therefore, the emergence of antipsychotics with a different pharmacological profile, belonging to the third generation, inspires cautious optimism regarding the metabolic consequences of antipsychotic therapy, including in the long-term stages. There is already evidence that this group of drugs is potentially characterized by a neutral or even beneficial effect on many metabolic parameters.

The aim: to conduct a comparative analysis of the dynamics of anthropometric and laboratory indicators of metabolic disturbances in patients with schizophrenia during therapy with second- and third-generation antipsychotics.

Material and methods. A total of 186 patients aged 18-60 years with a diagnosis of schizophrenia were examined and divided into groups depending on the therapy being taken. Upon hospitalization and before discharge (after 4 weeks of therapy), patients underwent a comprehensive assessment of metabolic parameters: body mass index, waist circumference, total body fat, total body fat percentage, visceral fat percentage, as well as glucose, triglyceride, total cholesterol, high-density lipoprotein, low-density lipoprotein, and very-low-density lipoprotein levels. The χ2, Kruskal-Wallis and Wilcoxon tests were used to compare variables.

Results. When assessing the dynamics of metabolic parameters in patients with schizophrenia during therapy with second-generation antipsychotics, a statistically significant increase was found in most parameters (p < 0.05), with the exception of high-density lipoprotein (p = 0.505) and low-density lipoprotein (p = 0.548). In the groups of patients taking third-generation antipsychotics, as well as during combination therapy, no significant changes were found (all p values ​​> 0.05).

Conclusion. The obtained data support the wider use of third-generation antipsychotics in clinical practice, particularly in patients with underlying risk factors or those who develop metabolic side effects during therapy.

Keywords

schizophrenia, metabolic syndrome, metabolic disorders, antipsychotics, therapy

PDF (Русский)

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