Correlation between clozapine use and metabolic syndrome in schizophrenic patients

Background: Clozapine, an atypical antipsychotic agent, is effective for relapse or refractory schizophrenia that has failed to respond to other antipsychotic medications. Despite its effectiveness, clozapine has a higher risk of metabolic syndrome than other antipsychotics. Objective: This research aimed to identify the correlation between clozapine and metabolic syndrome, such as obesity, cholesterol, and blood glucose levels, in schizophrenic patients at Ghrasia Mental Hospital, Yogyakarta, Indonesia. Method: This is a cross-sectional research. Subjects who met the inclusion criteria were randomly sampled from outpatients between November 2021 and February 2022. The research collected medical record data (characteristic patients, medication patterns, and body mass index) and analysed blood profiles (cholesterol and glucose levels). The data were analysed descriptively and statistically. Result: Among the 71 patients in this research, 37 (52.11) were male and 34 (47.89) were female, with an average age of 36-45 years. The treatment patterns of patients were as follows: 44 were taking only clozapine and 27 patients did not use clozapine. Clozapine was frequently combined with risperidone and haloperidol in this research. Bivariate analysis using Fisher's Exact test revealed no significant correlation between clozapine use, clozapine regimen (single or combined), duration of clozapine therapy (>= 5 years), and clozapine dose (high or low) with obesity, hypercholesterolemia, and hyperglycemia. Meanwhile, multivariate analysis revealed a significant correlation between gender and obesity (p < 0.05), with women having a 0.299 higher risk than men. The effects of age and duration of schizophrenia on hypercholesterolemia and hyperglycemia were insignificant. Conclusion: There was no correlation found between clozapine use and metabolic syndrome. Gender was found to have a significant correlation with obesity in the research.