Wednesday, May 20, 2015


If a 40 year old male suffering from chronic schizophrenia, is found to have a raised serum cholesterol and serum triglyceride. Should his treating physician lower his serum cholesterol?
What do you think?
Well, at the ( now on ) annual American Psychiatric Association meeting in Toronto, Dr Henry Nasrallah of the St Louis University School of Medicine in Missouri, presented the findings of CATIE ( Clinical Anti-Psychotic Trial of Intervention Effectiveness ). They studied the lipid profile of 1,460 schizophrenics  with an average of 40 years. They found that those with raised serum cholesterol and triglyceride had significantly better neurocognitive scores. These neurocognitive scores measures various aspect of neurocognitive functions, memory functions and also executive functions. Those with lower cholesterol and triglycerides, had poorer scores. These findings were in schizophrenics. It is important to note that 85% of the brain is lipids.
However, it is important to note that the study did not show that lowering the serum lipids, worsened the  neurocognitive scores. So it is not bidirectional.
However, I find this association interesting?
Should we allow schizophrenics to have raised serum cholesterol and triglycerides, so that we help the brain, but which may harm the heart? What then is the best for this patient?

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