Polycystic ovarian syndrome in patients with schizophrenia treated with atypical anti-psychotics: A case control study

Abstract

Objective: Objective was to compare the prevalence of probable polycystic ovarian syndrome (PCOS) in females treated with atypical anti-psychotics with normal controls. Aims: To compare the prevalence of PCOS in patients treated with atypical anti-psychotics and normal controls. To study the hormone profiles in these two groups. Methods: Cases consisted of 102 reproductive age females with schizophrenia treated with atypical anti-psychotics for ≥6 months and had gained ≥10% body weight. Control group was 123 age and BMI matched females. Menstrual history, physical examination for hirsuitism, acne, androgenic alopecia, anthropometrics measures, Ultrasound abdomen and hormone analysis were done. Results: Mean age of cases = 33.17 years (SD 8.9) and controls = 33.08 years (SD 5.6). Mean BMI of cases = 25.92 (SD 5.2) and controls = 25.03 (SD 4.3). Polycystic ovarian morphology of ovaries on ultra sound scan was significantly more in cases 49 (48%) than controls 16 (13.%) (P < 0.001). Probable PCOS was significantly more in atypical anti-psychotic treated females (n = 22, 21.56%) than in normal controls (n = 10, 8.13%) (P = 0.04). Atypical anti-psychotic treated patients with PCOS had significantly lower mean LH levels 6.69 mIU/L than those without PCOS 10.30 (P = 0.35). There was no significant difference in testosterone, FSH, prolactin, TSH and free T4 levels. Conclusion: Treatment with atypical anti-psychotics is associated with higher prevalence of PCOS. This has not been reported previously. The hormonal profile in these patients may be different with low testosterone and LH levels.