Public Defence: Trude Seselie Jahr Vedal
Cand.med. Trude Seselie Jahr Vedal at Institute of Clinical Medicine will be defending the thesis “The side effect burden of antipsychotic drugs - A naturalistic study with focus on metabolic disturbance” for the degree of PhD (Philosophiae Doctor).
Trial Lecture – time and place
See Trial Lecture.
- First opponent: Professor Olli Kampman, University of Tampere, Finland
- Second opponent: University Lecturer Mussie Msghina, Örebro University, Sweden
- Third member and chair of the evaluation committee: Associate Professor Suraj Thapa, Faculty of Medicine, University of Oslo
Chair of the Defence
Professor Emeritus Lars Weisæth, Faculty of Medicine, University of Oslo
Professor Erik G. Jönsson, Faculty of Medicine, University of Oslo
Antipsychotic-associated side effects
Use of antipsychotic drugs is considered a cornerstone in the treatment of psychotic disorders. However, their use is associated with a wide range of side effects, particularly metabolic, which may affect the patients’ health, life quality and treatment adherence.
The aim of this thesis was to investigate the side effect burden of antipsychotic drugs in a large naturalistic study of patients with severe mental disorders, taking sex, age and use of other psychotropic drugs into account. The patients underwent a thorough diagnostic workup, assessment of reported side effects using the UKU side effect rating scale and collection of blood samples and information about use of medication. Healthy controls were included for comparison.
We found that more than 75% of the patients reported side effects to some degree. Antipsychotics use was associated with sedation, weight gain and neurologic and sexual side effects. Female sex, increasing age and antipsychotic dose as well as antipsychotic polypharmacy was associated with more reported side effects.
We found significantly lower plasma levels of free thyroxine (fT4) in patients compared to controls (p<0.001). Further, lower fT4 was associated with use of antipsychotics in general and specific agents in monotherapy, while also with polypharmacy and reported weight gain.
We also found that use of antipsychotics was associated with increased calculated insulin resistance (p=0.007), with a significant mediating effect via altered adipokine serum levels (p<0.001). These associations remained significant while adjusting for BMI, suggesting a diabetogenic effect also independently of weight gain.
Overall, antipsychotic- associated side effects are common and factors influencing their occurrence should be taken into account when choosing and monitoring the treatment of severe mental disorders.
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