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

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 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.