Red Yeast Rice (RYR) supplementation in patients treated with second-generation antipsychotics.

Objective: Second-generation antipsychotics (SGAs) have a negative impact on metabolic syndrome (MetS) risk factors for their effects on body weight and on metabolic parameters. Statins are widely used in the treatment of dyslipidemia; less is known on the ability of statins to treat SGAs-induced dyslipidemia, and nutraceutical approaches may represent promising strategies in SGAs-treated patients. Red Yeast Rice (RYR), the fermented product of the Aspergillaceae mold Monascus purpureus (red yeast) grown on white rice, has been shown to have a cholesterol-lowering effect which can be ascribed to monacolin K, although other active compounds may play a role management of hyperlipidemia. The present study was aimed to explore the efficacy and safety of RYR treatment on clinical and metabolic parameters in a sample of subjects receiving SGAs.

Methods: Fifteen outpatients treated with SGAs assumed RYR at the oral daily dose of 200 mg/day (total monacolin K = 11.88 mg) for 30 days. Fasting levels of triglycerides, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and glucose were determined.

Results: RYR administration resulted in a statistically significant reduction of LDL (p = 0.029), corresponding to 11.0% decrease from baseline mean value. No significant differences in clinical and in other and metabolic parameters were observed.

Conclusions: Our findings suggest that RYR, at the daily dose of 200 mg for 30 days, could be a promising agent to prevent and/or treat SGAs-induced hyperlipidemia. However, future adequately-powered and well-designed studies with long-term follow-up should evaluate RYR effectiveness, as an alternative option to statins, on the SGAs-induced metabolic side effects.