Effects of Six Second Generation Antipsychotics on Body Weight and Metabolism – Risk Assessment and Results from a Prospective Study

A. Tschoner; J. Engl; M. Rettenbacher; M. Edlinger; S. Kaser; T. Tatarczyk; M. Effenberger; J. R. Patsch; W. W. Fleischhacker; C. F. Ebenbichler

doi:10.1055/s-0028-1100425

Pharmacopsychiatry 2009; 42(1): 29-34
DOI: 10.1055/s-0028-1100425

Original Paper

Effects of Six Second Generation Antipsychotics on Body Weight and Metabolism – Risk Assessment and Results from a Prospective Study

A. Tschoner¹ , J. Engl¹ , M. Rettenbacher² , M. Edlinger² , S. Kaser¹ , T. Tatarczyk¹ , M. Effenberger¹ , J. R. Patsch¹ , W. W. Fleischhacker² , C. F. Ebenbichler¹

¹Department of Internal Medicine I, Medical University Innsbruck, Innsbruck, Austria
²Department of Biological Psychiatry, Medical University Innsbruck, Austria

Abstract

Background: Due to the association of second generation antipsychotics (SGAs) with weight gain and alterations of glucose and lipid homeostasis, we aimed to group six commonly prescribed SGAs into classes of differing risks.

Methods: Twenty-eight patients meeting the criteria for a diagnosis of schizophrenic disorder according to ICD-10 were assigned to monotherapy with olanzapine, clozapine, quetiapine, amisulpride, ziprasidone or risperidone. The levels of glucose and lipid metabolism were assessed before and after 28 days of treatment.

Results: Based on cluster analysis, olanzapine and clozapine were found to constitute a high-risk group for metabolic dysregulation while amisulpride, quetiapine, risperidone and ziprasidone could be assigned to a non-high-risk group. Subjects from the high-risk group displayed significant weight gain with concomitant increases of HOMA-IR, levels of insulin, total cholesterol, TG, LDL-C and leptin. No significant changes were observed in the non-high-risk group.

Conclusion: The results of this study support the conclusion of the Consensus Development Conference on Antipsychotic Drugs and Obesity and Diabetes that certain SGAs are associated with a higher risk for weight gain, insulin resistance and dyslipidemia.

Full Text

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Correspondence

C. F. EbenbichlerMD

Department of Internal Medicine I

Medical University Innsbruck

Anichstraße 35

6020 Innsbruck

Austria

Phone: +43/512/504/285 37

Fax: +43/512/504/285 39

Email: Christoph.Ebenbichler@i-med.ac.at