Metabolic Adverse Effects of Antipsychotic Drugs in Patients with SchizophreniaAuthor(s): Zeina A. Althanoon*
Objective: Dysregulation of glucose and lipid metabolism is a common adverse effect of antipsychotic medications. The purpose of this study was to compare the efficacy and tolerability of aripiprazole and olanzapine in people with schizophrenia and schizophrenia-like psychosis.
Methods: Eighty schizophrenia patients were divided into two groups (Olanzapine and Aripiprazole). The diagnosis of schizophrenia was obtained using the American Psychiatric Association's DSM-V criteria (APA). Additionally, a control group of 40 seemingly healthy volunteers was included. BMI was estimated using the Quetelet index (Body weight/Height2) for patients before and after therapy, as well as for controls. Before and after 6 months of treatment, the control and patient groups were evaluated for changes in body weight, Body Mass Index (BMI), leptin, Fasting Blood Sugar (FSG), and serum lipid profile (triglycerides ,TG ; High-Density Lipoprotein (HDL), Low-Density Lipoprotein (LDL), and Total Cholesterol (TC).
Results: The results indicated that there were statistically significant variations in body weight, body mass index, waist circumference, fasting blood sugar, leptin, and lipid profile between patients administered olanzapine or aripiprazole and healthy controls (P<0.001). The study discovered that patients receiving olanzapine experienced a highly significant increase in body weight, BMI, waist circumference, fasting blood sugar, and lipid profile(P<0.001), whereas those receiving aripiprazole did not experience any significant changes in body weight, BMI, waist circumference, fasting blood sugar, or lipid profile. With the exception of HDL-C, statistical comparisons between the two groups for body weight, BMI, WC, blood sugar, and lipid profile were significant(P<0.001).
Conclusions: Aripiprazole and olanzapine therapy demonstrated a substantial influence on metabolic indicators.Aripiprazole appears to induce less unfavorable metabolic alterations. Olanzapine resulted in a considerable increase in leptin, FSG and lipid profile whereas aripiprazole resulted in a minor (nonsignificant) increase in these biochemical measures. Thus, it is recommended that careful monitoring of body weight, BMI, leptin, fasting blood glucose, and serum lipid levels be addressed when using atypical antipsychotics for an extended period of time especialy those on olanzapine therapy for patients with shizophrenia.