Treatment With Rosuvastatin for Severe Dyslipidemia in Patients With Schizophrenia and Schizoaffective Disorder

Marc De Hert, M.D., Ph.D.; Dita Kalnicka, M.D.; Ruud van Winkel, M.D.; Martien Wampers, Ph.D.; Linda Hanssens, M.S., M.S.P.H.; Dominique Van Eyck, M.D.; Andre Scheen, M.D., Ph.D.; and Joseph Peuskens, M.D., Ph.D.

Background: Mortality rates in patients with schizophrenia are double compared to those in the general population, with cardiovascular disease causing 50% of the excess. Lowering low-density lipoprotein (LDL) cholesterol is recognized as a primary target for the prevention of cardiovascular mortality according to the National Cholesterol Education Program-Adult Treatment Panel III. Use of lipid-lowering drugs such as statins is recommended when lifestyle changes are not sufficient to reach the LDL goal. The efficacy and safety of rosuvastatin treatment were evaluated in schizophrenic patients.

Method: 100 schizophrenic patients with severe dyslipidemia were identified. All were treated with antipsychotics. Fifty-two patients were treated with rosuvastatin and compared with 48 who did not receive statin treatment. All patients were screened for cardiovascular risk factors and examined at baseline. The effects of lipid-lowering medication on lipid profile, glucose homeostasis, and components of metabolic syndrome were evaluated at 3-month follow-up. The study began in 2003, and all data available until December 2005 are reported.

Results: After 3 months of statin therapy, a significant decrease in triglycerides, total cholesterol, LDL cholesterol, and non-high-density lipoprotein (non-HDL) cholesterol and in associated ratios (LDL/HDL, total cholesterol/HDL) was observed. The difference was highly significant compared to patients not receiving statin treatment. No significant changes occurred in HDL cholesterol, body mass index and waist circumference, or glucose homeostasis. The only component of metabolic syndrome affected by statin therapy was the serum triglyceride level.

Conclusion: Rosuvastatin proved effective in the management of dyslipidemia in patients with schizophrenia treated with antipsychotics. More complex treatment may be required for associated metabolic disturbances.

(J Clin Psychiatry 2006;67:1889-1896)

Received April 1, 2006; accepted May 16, 2006. From the University Psychiatric Center, Katholieke Universiteit Leuven, Kortenberg, Belgium (Drs. De Hert, van Winkel, Wampers, Van Eyck, and Peuskens); the Department of Psychiatry, Medical Faculty in Hradec Kralove, Charles University in Prague, Hradec Kralove, Czech Republic (Dr. Kalnicka); and the Departments of Epidemiology and Public Health (Ms. Hanssens) and Diabetes, Nutrition and Metabolic Disorders CHU Sart Tilman (Dr. Scheen), University Liege, Liege, Belgium.

Dr. De Hert has been a consultant for, received grant/research support and honoraria from, and been on the speakers/advisory boards of AstraZeneca, Lundbeck JA, Janssen-Cilag, Eli Lilly, Pfizer, Sanofi, and Bristol-Myers Squibb. Dr. Van Eyck has been on the speakers/advisory board of Sanofi. Dr. Scheen has been on the speakers/advisory boards of Pfizer, Sanofi-Aventis, Eli Lilly, AstraZeneca, Novo Nordisk, and MSD. Dr. Peuskens has been a consultant for, received grant/research support and honoraria from, and been on the speakers/advisory boards of Janssen-Cilag, AstraZeneca, Eli Lilly, Bristol-Myers Squibb, Pfizer, Lundbeck, and Sanofi Synthelabo. Drs. Kalnicka, van Winkel, and Wampers and Ms. Hanssens report no financial affiliation or other relationship relevant to the subject of this article.

Corresponding author and reprints: Marc De Hert, M.D., Leuvense Steenweg 517, 3070 Kortenberg, Belgium (e-mail: marc.de.hert@uc-kortenberg.be).