BackgroundrnThere is evidence that people with mental illness are more likely to suffer fromrnmetabolic syndrome compared to the general population, especially those takingrnsecond generation antipsychotics (SGAs). However, there is dearth of datarncomparing the metabolic side effects of first generation and second generationrnantipsychotics. SGAs are also newly introduced in the Ethiopian setting. Thernobjective of this study was to explore the potential metabolic side effect of SGAs.rnMethodrnDesign: A cross sectional study, comparing the prevalence of metabolic syndromernin patients with severe mental illness taking FGAs or SGAs (for at least 6weeks)rnSetting: Study was conducted at Amanuel Specialized Mental Hospital in Ethiopiarnand participants were recruited from the inpatient departments.rnParticipants: An initial sample size of 150 was required for the detection of a 50%rndifference in the rate of metabolic syndrome between SGAs and FGAs at a 1:1rnallocation ratio. However, only one hundred participants were recruited becausernSGAs were often running out off stock and took longer than anticipated to getrnadequate number on SGAs. However, candidate believes 100 participants would bernadequate for this kind of exploratory and hypothesis generating study.rnMeasurement: Data on basic demographics, including relevant family history,rndietary habit, clinical information (diagnosis, duration of illness and medication) andrnmetabolic profile was collected. Diagnosis of metabolic syndrome was madernaccording to the criteria of the International Diabetes Federation.rnAnalysis: Focused on simple descriptive approaches with limited bivariate analysis.rnResultrn5rnIn the 4month study period 100 participants were included, who fulfilled the inclusionrncriteria. For ease of access, all participants were inpatients. Sixty six percent (n=66)rnwere male and 34% (n=34) were female. The mean age of the patients wasrn31.1years (SD 9.7). Fifty four (n=54) percent of the participants were prescribedrnSGA and 46 of the participants were prescribed FGA. According to IDF criteria 8.5%rn(n= 8) met the diagnostic criteria for metabolic syndrome. The prevalence ofrnmetabolic syndrome in FGA group was 2.3% and SGA group was 14%. (Crude OR=rn7; 95% CI = 0.82, 59.3; P = .074).rnConclusionrnOverall, the prevalence of metabolic syndrome is relatively low, especially amongrnthose taking FGAs. Although the study failed to find statistically significant differencernbetween those taking SGAs and FGAs, there was a strong trend of associationrnbetween SGAs and metabolic syndrome.rnFurther confirmatory studies are required; however, taken together with the broaderrnliterature regarding SGAs and metabolic syndromes, careful screening andrnmonitoring has to be part of standard clinical practice.rnIntroduction