ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Ethnopharmacology
Long-term Traditional Chinese Medicine Use and Incidence of Metabolic Syndrome in Schizophrenia: A Retrospective Cohort Study
JingShuang Zhang
Wei-Jun Gu
Ying-Hua Huang
Mei Guo
Xiamen City Xianyue Hospital, Xiamen, China
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Abstract
Objective: To assess the impact of medium- to long-term traditional Chinese medicine (TCM) combined with antipsychotics on metabolic syndrome (MetS) in schizophrenia patients and explore its prevalence and influencing factors. Methods: A retrospective cohort study included 897 inpatients (≥18 years, good medication adherence, hospitalized ≥6 months) with schizophrenia (2022–2024). Divided into TCM-exposed (n=163) and non-exposed (n=734) groups, MetS incidence was tracked. Univariate analysis screened confounders, followed by multivariate logistic regression to calculate odds ratios (OR). Results: MetS prevalence was 27.53% overall; 17.18% in the TCM group vs. 29.84% in the non-TCM group. TCM group had lower central obesity (29.5% vs. 39.8%) and hyperglycemia (13.50% vs. 21.8%). Multivariate analysis showed: higher education (>12 years, OR=0.45), TCM use (OR=0.50), risperidone (OR=0.54), aripiprazole (OR=0.39) were protective; quetiapine (OR=1.86), clozapine (OR=1.74), and high BMI (OR=1.39) were risk factors. Conclusion: MetS is common in schizophrenia. TCM, aripiprazole, risperidone, and higher education reduce MetS risk, while quetiapine, clozapine, and high BMI increase it. Long-term TCM may mitigate antipsychotic-induced metabolic harm, offering a feasible option for chronic patients.
Summary
Keywords
antipsychotic drugs, Metabolic syndrome (MetS), Retrospective cohort study, Schizophrenia, Traditional Chinese medicine (TCM)
Received
02 October 2025
Accepted
17 February 2026
Copyright
© 2026 Zhang, Gu, Huang and Guo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Mei Guo
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