Adjunctive effects of aripiprazole on metabolic profiles: comparison of patients treated with olanzapine to patients treated with other atypical antipsychotic drugs

Prog Neuropsychopharmacol Biol Psychiatry. 2013 Jan 10;40:260-6. doi: 10.1016/j.pnpbp.2012.10.010. Epub 2012 Oct 18.

Abstract

Metabolic abnormalities are serious adverse effects of atypical antipsychotic treatment. This study aims to determine the effects of adjunctive aripiprazole on metabolic profiles among patients receiving treatment with atypical antipsychotics, and to examine whether these effects are different from that of pre-existing atypical antipsychotics. In the 8-week open-label trial, aripiprazole was added to patients who were receiving treatment with atypical antipsychotics and had experienced weight gain or dyslipidemia. The dosage of pre-existing atypical antipsychotics was fixed, while the dosage of aripiprazole ranged from 5 to 20 mg/day during the study period. Metabolic profiles, including body weight, body mass index (BMI), plasma levels of fasting glucose, triglycerides, total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, and adiponectin, were measured at baseline and week 8. As a result, 43 subjects (16 males and 27 females, mean age: 37.8±10.8 years) completed the study. The pre-existing antipsychotics were olanzapine (n=12), risperidone (n=19), quetiapine (n=6) and amisulpiride (n=6). The mean dosage of adjunctive aripiprazole was 9.9±3.2 mg/day. After the aripiprazole-augmented regimen for 8 weeks, patients treated with olanzapine had significant decreases in body weight, BMI and triglyceride levels, and had significant increases in adiponectin levels. For patients treated with other atypical antipsychotics, none of the metabolic parameters significantly changed after administering aripiprazole. In conclusion, aripiprazole-augmented treatment might be beneficial for the metabolic regulation of patients being treated with a stable dose of olanzapine, but not for those treated with other atypical antipsychotics. A long-term, randomized, double-blind controlled design is suggested to confirm these findings.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiponectin / blood
  • Adult
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / pharmacology
  • Antipsychotic Agents / therapeutic use*
  • Aripiprazole
  • Benzodiazepines / adverse effects
  • Benzodiazepines / pharmacology
  • Benzodiazepines / therapeutic use*
  • Blood Glucose / drug effects*
  • Body Mass Index
  • Body Weight / drug effects*
  • Female
  • Humans
  • Lipids / blood
  • Male
  • Middle Aged
  • Obesity / blood
  • Obesity / chemically induced
  • Olanzapine
  • Piperazines / adverse effects
  • Piperazines / pharmacology
  • Piperazines / therapeutic use*
  • Prospective Studies
  • Psychotic Disorders / blood
  • Psychotic Disorders / drug therapy*
  • Psychotic Disorders / physiopathology
  • Quinolones / adverse effects
  • Quinolones / pharmacology
  • Quinolones / therapeutic use*
  • Weight Gain / drug effects

Substances

  • Adiponectin
  • Antipsychotic Agents
  • Blood Glucose
  • Lipids
  • Piperazines
  • Quinolones
  • Benzodiazepines
  • Aripiprazole
  • Olanzapine