An open-label prospective study to assess metabolic side effects with atypical and typical antipsychotic drugs in patients with schizophrenia

• Main Authors: Prasanna Kumar Neredumilli, G Bhagya Rao
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2014-01-01
• Series: Archives of Mental Health
• Subjects: antipsychotics; metabolic side effects; weight gain
• Online Access: http://www.amhonline.org/article.asp?issn=2589-9171;year=2014;volume=15;issue=2;spage=245;epage=250;aulast=Neredumilli;type=0
• ISSN: 2589-9171; 2589-918X

Background: Schizophrenia is a major psychiatric illness comprising thought, perception, emotion, movement, and behaviour. Pharmacotherapy plays an important role in managing this disorder, comprising mostly typical and atypical antipsychotics. Treatment with antipsychotics can cause metabolic side effects leading to medical disorders among the patients suffering from schizophrenia. Aims: To study the effects on glucose and lipid metabolism with the use of atypical and typical antipsychotics in the treatment of schizophrenia. Methods: The present study is a 12 weeks open label prospective study of antipsychotic drugs olanzapine, risperidone and haloperidol in patients with schizophrenia. 80 patients having diagnosis of schizophrenia according to ICD-10 are assigned to treatment with olanzapine (N=20), risperidone (N=20) and haloperidol (N=40). Assessment for analysis include weight, body mass index(BMI), fasting blood glucose(FBS), postprandial blood glucose (PPBS) at baseline and at 4th week ,8th week and 12th week. Lipid profile is assessed at baseline and 12th week. Results: Out of 80 subjects, only 65 patients completed the study; there are 15 dropouts. At the end of 12 weeks in haloperidol group, there is a mean increase of 3.2 mg/dl in FBS and 2.71 mg/dl PPBS and mean decrease of 2.76 mg/dl in serum cholesterol levels. In olanzapine group there is a mean increase of 6.3 mg/dl in FBS and 3.7 mg/dl in PPBS and mean increase of 7.8 mg/dl in serum cholesterol. In risperidone group, there is mean increase of 2.3 mg/dl in FBS and 2.8 mg/dl in PPBS and mean increase of 0.98 mg/dl in serum cholesterol. Conclusions: Metabolic side effects are more with atypical antipsychotics. Regular blood monitoring of metabolic parameters should be strictly implemented. Consideration should be given for prescribing drugs like metformin for antipsychotic induced weight gain along with dietary management and lifestyle change if deemed necessary.