{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:49:50Z","timestamp":1791355790032,"version":"4.3.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Metabolic syndrome is a major contributor to premature cardiovascular morbidity and mortality among people with schizophrenia. Antipsychotic polypharmacy is common, but its independent metabolic burden remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare metabolic syndrome in patients receiving stable long-term antipsychotic monotherapy or polypharmacy and to examine high metabolic-risk exposure, chlorpromazine-equivalent dose, and long-acting injectable (LAI) use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 370 adults with schizophrenia spectrum disorders receiving an unchanged antipsychotic regimen for at least five years at a community mental health center. Patients received monotherapy (n=144) or polypharmacy (n=226). Metabolic syndrome was defined using International Diabetes Federation criteria. Antipsychotic dose was standardized to chlorpromazine equivalents, and multivariable logistic regression was used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Metabolic syndrome was present in 143 patients (38.6%) and was numerically more frequent with polypharmacy than monotherapy (41.2% vs. 34.7%, p=0.216). LAI use (67.3% vs. 37.5%, p&amp;lt;0.001) and median chlorpromazine-equivalent dose (1010.0 vs. 454.5 mg\/day, p&amp;lt;0.001) were higher with polypharmacy. However, neither LAI use (adjusted OR\u00a0=\u00a01.220, 95% CI 0.767-1.941, p=0.401) nor chlorpromazine-equivalent dose per 100 mg\/day (adjusted OR\u00a0=\u00a01.003, 95% CI 0.954-1.055, p=0.899) was independently associated with metabolic syndrome. Current smoking remained associated with metabolic syndrome (adjusted OR\u00a0=\u00a01.996, 95% CI 1.251-3.185, p=0.004).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this selected cohort with stable long-term treatment, polypharmacy was associated with greater dose and LAI exposure, but independent associations of treatment modality, current dose, LAI use, or olanzapine\/clozapine exposure with metabolic syndrome were not detected. Comprehensive cardiometabolic monitoring and smoking cessation remain priorities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1909155","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:53:34Z","timestamp":1791352414000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Metabolic syndrome in stable long-term antipsychotic monotherapy and polypharmacy among patients with schizophrenia: a real-world comparative study"],"prefix":"10.3389","volume":"17","author":[{"given":"Haluk","family":"Usta","sequence":"first","affiliation":[{"name":"Department of Psychiatry, University of Health Sciences Erenk\u00f6y Training and Research Hospital for Mental and Neurological Disorders","place":["\u0130stanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didem","family":"Be\u015fikci Kele\u015f","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Health Sciences Erenk\u00f6y Training and Research Hospital for Mental and Neurological Disorders","place":["\u0130stanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2020.177901","article-title":"The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia","volume":"177","author":"Keepers","year":"2020","journal-title":"Am J Psychiatry"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20252","article-title":"Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: A systematic review and 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