Document Detail


Weight gain, metabolic parameters, and the impact of race in aggressive inpatients randomized to double-blind clozapine, olanzapine or haloperidol.
MedLine Citation:
PMID:  19269139     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The second-generation antipsychotic agents clozapine and olanzapine have been associated with weight gain and increased lipid and glucose blood levels. Since some of the neurotransmitters that are impaired in aggressive patients are involved in lipid/glucose metabolism, aggressive patients may represent a subgroup with a differential profile of adverse metabolic reactions to these medications. The goal of this study was to assess the effects of clozapine and olanzapine in comparison to the first-generation agent haloperidol on these metabolic parameters in aggressive patients with schizophrenia. METHOD: 110 inpatients with schizophrenia and a history of physical assaults were included in a randomized double-blind 12-week study. Fasting glucose, cholesterol and triglycerides were collected at baseline and at the end of the study. Ninety-three patients provided blood samples at baseline and at least at one point after randomization to clozapine (N=34), olanzapine (N=31) or haloperidol (N=28). RESULTS: There were significant differences among the three medication groups in weight gain and in increases in blood lipids and glucose. Patients on haloperidol showed no increase on any of these parameters. Patients on olanzapine gained the most weight, but patients on clozapine had the greatest increases in cholesterol, triglyceride, and glucose. An effect of ethnicity was observed, as African-American patients were more likely to develop metabolic abnormalities than other ethnic groups, especially on clozapine. CONCLUSIONS: In this prospective randomized trial, clozapine and olanzapine were associated with weight gain. Clozapine was associated with increases in both lipids and glucose. This effect was most prominent in the African-American patients.
Authors:
Menahem Krakowski; Pal Czobor; Leslie Citrome
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-03-09
Journal Detail:
Title:  Schizophrenia research     Volume:  110     ISSN:  0920-9964     ISO Abbreviation:  Schizophr. Res.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-24     Completed Date:  2009-07-07     Revised Date:  2010-09-02    
Medline Journal Info:
Nlm Unique ID:  8804207     Medline TA:  Schizophr Res     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  95-102     Citation Subset:  IM    
Affiliation:
Nathan Kline Institute for Psychiatric Research, Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States. Krakow@nki.rfmh.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Aggression / drug effects*
Analysis of Variance
Antipsychotic Agents / therapeutic use*
Benzodiazepines / therapeutic use
Blood Glucose / drug effects*
Body Mass Index
Cholesterol / blood
Clozapine / therapeutic use
Double-Blind Method
Ethnic Groups
Female
Haloperidol / therapeutic use
Humans
Inpatients
Lipid Metabolism / drug effects*
Male
Middle Aged
Prospective Studies
Schizophrenia / drug therapy*,  physiopathology
Weight Gain / drug effects*
Young Adult
Grant Support
ID/Acronym/Agency:
MH 58341/MH/NIMH NIH HHS
Chemical
Reg. No./Substance:
0/Antipsychotic Agents; 0/Blood Glucose; 12794-10-4/Benzodiazepines; 132539-06-1/olanzapine; 52-86-8/Haloperidol; 57-88-5/Cholesterol; 5786-21-0/Clozapine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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