SU113. Clozapine Exposure Further Impairs Cardiovascular Fitness When Compared to Other Atypical Antipsychotics in a Cohort of Chronic Schizophrenia Patients
Bibliographic record
Abstract
Background: Individuals with schizophrenia have consistently demonstrated impaired cardiovascular fitness, as indicated by lower peak aerobic power (VO2peak). It is of interest whether antipsychotics, especially clozapine, significantly affect VO2peak in these individuals. We investigated the relationship between antipsychotic dose and VO2peak, and also compared VO2peak between those receiving primarily clozapine vs other atypical antipsychotics. Methods: Thirty participants with DSM-IV schizophrenia or schizoaffective disorder (mean age: 31.0 ± 6.6 y; 10 F, 20 M) were divided into clozapine (n = 15) and nonclozapine (n = 15) groups. A group of healthy age- and sex-matched controls (n = 15) was also included. The patients were treated with a mix of one or more atypical antipsychotics (clozapine, olanzapine, aripiprazole, quetiapine, risperidone, paliperidone, and asenapine). Each participant completed maximal symptom-limited exercise testing on a cycle ergometer for the assessment of VO2peak. Hierarchical multiple regression was used to examine the association of a dose increase with VO2peak after controlling for body mass index (BMI). Analysis of covariance was used to compare VO2peak between the clozapine and nonclozapine groups after controlling for BMI and antipsychotic dose. Results: Rating of perceived exertion was not significantly different across the 3 groups (P = .693). The mean chlorpromazine equivalent (CPZE) was 731.3 ± 386.5 mg/d. After controlling for BMI, every 100 mg/d increase in CPZE was associated with approximately a 1 ml/kg/min reduction in VO2peak (B = −0.92, SE = 0.44, P = .046). Moreover, the clozapine group demonstrated further reduced VO2peak as compared to the nonclozapine group after controlling for BMI and CPZE (18.9 ± 7.9 vs 26.5 ± 10.3 ml/kg/min; F(1,26) = 4.55, P = .042). The nonclozapine group in turn had significantly lower VO2peak than the healthy control group (26.5 ± 10.3 vs 37.3 ± 10.2 ml/kg/min; t = −2.90, P = .007). Conclusion: Antipsychotics affect VO2peak in a dose-dependent manner that is independent of BMI in individuals with schizophrenia. Those receiving clozapine have further reduced VO2peak than those receiving other atypical antipsychotics. Potential mechanisms are not clear, but altered activity of various peripheral receptors, as well as altered metabolism, by antipsychotics may contribute to impaired cardiovascular fitness in schizophrenia.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".