Blood lactate levels in patients receiving first- or second- generation antipsychotics

Croat Med J. 2011 Feb;52(1):41-7. doi: 10.3325/cmj.2011.52.41.

Abstract

Aim: To compare the blood lactate levels between patients with psychotic disorder receiving first- and those receiving second-generation antipsychotics.

Methods: The study was conducted at the psychiatric inpatient and outpatient clinics of the Split Clinical Hospital from June 6, 2008 to October 10, 2009. Sixty patients with psychotic disorder who were assigned to 6-month treatment were divided in two groups: 30 received haloperidol (first generation antipsychotic) and 30 received olanzapine (second generation antipsychotic). Blood lactate levels, other metabolic parameters, and scores on the extrapyramidal symptom rating scale were assessed.

Results: Patients receiving haloperidol had significantly higher blood lactate levels than patients receiving olanzapine (P < 0.001). They also more frequently had parkinsonism, which was significantly correlated with both haloperidol treatment at 1 month (P < 0.001) and 6 months (P = 0.016) and olanzapine treatment at baseline (P = 0.016), 3 months (P = 0.019), and 6 months (P = 0.021). Also, patients receiving haloperidol had significant correlation between blood lactate and dystonia at 1 month (P < 0.001) and 6 months (P = 0.012) and tardive dyskinesia at 1 month (P = 0.032). There was a significant difference between the treatment groups in lactate levels at all points from baseline to month 6 (P < 0.001).

Conclusion: It is important to be aware of the potential effect of haloperidol treatment on increase in blood lactate levels and occurrence of extrapyramidal side effects. Therefore, alternative antipsychotics should be prescribed with lower risk of adverse side effects.

Trial registration: ClinicalTrials.gov NCT01139463.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adult
  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / agonists
  • Benzodiazepines* / administration & dosage
  • Benzodiazepines* / adverse effects
  • Dopamine Antagonists / administration & dosage
  • Dopamine Antagonists / adverse effects
  • Drug Monitoring
  • Haloperidol* / administration & dosage
  • Haloperidol* / adverse effects
  • Humans
  • Lactic Acid / metabolism*
  • Male
  • Middle Aged
  • Movement Disorders / diagnosis
  • Movement Disorders / etiology
  • Movement Disorders / metabolism*
  • Olanzapine
  • Parkinson Disease, Secondary / chemically induced
  • Parkinson Disease, Secondary / diagnosis
  • Parkinson Disease, Secondary / metabolism*
  • Psychiatric Status Rating Scales
  • Psychotic Disorders* / complications
  • Psychotic Disorders* / drug therapy
  • Psychotic Disorders* / metabolism
  • Psychotic Disorders* / physiopathology
  • Selective Serotonin Reuptake Inhibitors / administration & dosage
  • Selective Serotonin Reuptake Inhibitors / adverse effects
  • Treatment Outcome

Substances

  • Antipsychotic Agents
  • Dopamine Antagonists
  • Serotonin Uptake Inhibitors
  • Benzodiazepines
  • Lactic Acid
  • Haloperidol
  • Olanzapine

Associated data

  • ClinicalTrials.gov/NCT01139463