A comparative study of metabolic side effects of risperidone and olanzapine in the treatment of schizophrenia

Lavanya Nagaraj; Naveen Kumar Madalageri

doi:10.18203/2319-2003.ijbcp20194803

Authors

Lavanya Nagaraj Department of Pharmacology, Sree Narayana Institute of Medical Science, Chalakka, Ernakulam, Kerala, India
Naveen Kumar Madalageri Department of Pharmacology, Al Azhar Medical College and Super speciality hospital, Ezhalloor, Thodupuzha, Kerala, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20194803

Keywords:

Risperidone, Olanzapine, Atypical antipsychotics, Metabolic side effects

Abstract

ABSTRACT

Background: Schizophrenia is one of most serious chronic psychiatric disorder, which affects about 1% of population. Treatment of schizophrenia comprises of typical antipsychotics and or atypical antipsychotics. Typical antipsychotics like haloperidol have extrapyramidal side effects which limit their use in chronic cases. Atypical antipsychotics though have better treatment response, they have metabolic side effects like hypercholesteremia, hypertriglyceridemia and hyperglycaemia. As there is paucity of data in Indian population the present study has been taken up to compare the metabolic side effects of risperidone and olanzapine in the treatment of schizophrenic patients in a tertiary care hospital.

Methods: It was a comparative study conducted on 60 patients of Schizophrenia for one year in a tertiary care hospital. The study subjects were randomly assigned into 2 groups of 30 patients each, where group 1 were treated with atypical antipsychotic drug risperidone and group 2 with Olanzapine and both groups received the treatment for one year. Metabolic side effects like hypercholesteremia, hypertriglyceridemia and hyperglycaemia were evaluated and compared over a period of one year.

Results: Both risperidone and olanzapine were associated with comparable baseline to endpoint increase in metabolic side effects. However, risperidone treated subjects had significantly less metabolic side effects compared to olanzapine.

Conclusions: Apart from total cholesterol and triglycerides, other metabolic side effects were less in risperidone treated patients than olanzapine treated patients.

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References

Finkel B, Goodman C, Melamed Y, Naser M, Andreyev P, Segev Y, et al. Difference in metabolic side effects of typical and atypical antipsychotic treatment in elderly individual with long term schizophrenia. Hong Kong J Psychiatr. 2009;19:103-6.

Goeb JL, Marco S, Duhamel A, Kechid G, Bordet R, Thomas P, et al. Metabolic side effects of risperidone in early onset schizophrenia. Encephale. 2010;36(3):242-52.

Perez-Iglesias R, Crespo-Facorro B, Amado JA, Garcia-Unzueta MT, Ramirez-Bonilla ML, Gonzalez-Blanch C, et al. A 12-week randomized clinical trial to evaluate metabolic changes in drug-naive, first-episode psychosis patients treated with haloperidol, olanzapine, or risperidone. J Clin Psychiatr. 2007;68(11):1733-40.

Meyer JM. A retrospective comparison of weight, lipid, and glucose changes between risperidone and olanzapine treated inpatients:metabolic outcomes after 1year. J Clin Psychiatr. 2002;63:425-33.

Nuttall FQ. Body Mass Index: Obesity, BMI, and Health: A Critical Review. Nutr Today. 2015;50(3):117-28.

Kapur S, Remington G. Atypical Antipsychotics: New Directions and New Challenges in the Treatment of Schizophrenia. Ann Rev Med. 2001;52:503-17.

Allison DB, Mentor JL, Moonseong H, Chandler LP, Cappelleri JC, Infante MC, et al. Antipsychotic-Induced Weight Gain. A Comprehensive Res Synthesis Am J Psychiatr. 1999;156:1686-96.

Basson BR, Kinon BJ, Taylor CC, Szymanski KA, Gilmore JA, Tollefson GD. Factors influencing acute weight change in patients with Schizophrenia treated with olanzapine, Haloperidol, or risperidone. J Clin Psychiatr. 2001;62(4):231-8.

Wetterling T. Body weight gain with atypical antipsychotics. A comparative review. Drug Safety. 2001;24(1):59-73.

Haddad P. Weight change with atypical antipsychotics in the treatment of Schizophrenia. J Psychopharmacol. 2005;19:16-27.

Lee E, Leung CM, Wong E. Atypical antipsychotics and weight gain in Chinese patients: A Comparison of olanzapine and risperidone. J Clin Psychiatr. 2004;65(6):864-6.

Conley RR, Mahmoud R. A Randomized Double-Blind Study of Risperidone and Olanzapine in the Treatment of Schizophrenia or Schizoaffective Disorder. Am J Psychiatr. 2001;158:765-74.

Basson BR, Kinon BJ, Taylor CC, Szymanski KA, Gilmore JA, Tollefson GD. Factors influencing acute weight change in patients with Schizophrenia treated with olanzapine, Haloperidol, or risperidone. J Clin Psychiatr. 2001;62(4):231-8.

Rettenbacher MA, Ebenbichler C, Hofer A, Kemmler G, Baumgartner S, Edlinger M, et al. Early changes of plasma lipids during treatment with atypical antipsychotics. Int Clin Psychopharmacol. 2006;21(6):369-72.

Welborn TA, Dhaliwal SS and BennettSA. Waist-hip ratio is the dominant risk factor predicting cardiovascular death in Australia. Med J Australia. 2003;179 (11/12):580-5.

Lindenmayer JP, Czobor P, Volavka J, Citrome L, Sheitman B, McEvoy JP, et al. Changes in Glucose and Cholesterol Levels in Patients With Schizophrenia Treated With Typical or Atypical Antipsychotics. Am J Psychiatr. 2003;160:290-6.

Nasrallah HA, Newcomer JW. Atypical antipsychotics and metabolic dysregulation: evaluating the risk/benefit equation and improving the standard of care. J Clin Psychopharmacol. 2004:7-14.

Eder IU, Ebenbichler C, Fleischhacker WW. Olanzapine-induced weight gain and disturbances of lipid and glucose metabolism. Essentials Psychopharmacol. 2005;6(2):112-7.

Del Valle MC, Loebel AD, Murray S, Yang R, Harrison DJ, Cuffel BJ. Change in Framingham Risk Score in Patients with Schizophrenia:A Post Hoc Analysis of a Randomized, Double-Blind, 6-Week Trial of Ziprasidone and Olanzapine. J Clin Psychiatr, Primary Care Companion. 2006;8:329-33.

Monteleone P, Martiadas V, Maj M. Management of schizophrenia with obesity, metabolic and endocrinological disorders. Psychiatr Clin N Am. 2009;32:775-94.

Ingole S, Belorkar NR, Waradkar P, Shrivastava M. Comparison of effects of olanzapine and risperidone on body mass index and sugar level in schizophrenic patients. Indian J Physiol Pharmacol. 2009;53(1):47-54.