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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 Psychiatry. 2007 Nov; 68(11):1733-40.JC

Abstract

OBJECTIVE

This study examined the main metabolic side effects induced by antipsychotic treatment in a cohort of first-episode drug-naive subjects.

METHOD

A randomized, open-label, prospective clinical trial was conducted. Participants were 145 consecutive subjects included in a first-episode psychosis program (PAFIP) from February 2002 to February 2005, experiencing their first episode of psychosis (DSM-IV codes 295, 297, and 298), and never treated with antipsychotic medication. Patients were assigned to haloperidol, olanzapine, or risperidone treatment during 12 weeks. The main outcome measures were changes at 12 weeks in body weight; body mass index; and 12-hours-fasting morning levels of total cholesterol, tri-glycerides, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein cholesterol, glucose, homeostasis model assessment (HOMA) index, and insulin.

RESULTS

At the endpoint, 128 patients were evaluated (88.3%). The mean doses were haloperidol = 4.2 mg/day, olanzapine = 12.7 mg/day, and risperidone = 3.6 mg/day. A significant weight gain was observed with the 3 antipsychotics: haloperidol = 3.8 (SD = 4.9) kg, olanzapine = 7.5 (SD = 5.1) kg, and risperidone = 5.6 (SD = 4.5) kg. Metabolic parameters showed a worsening lipid profile with the 3 treatments (statistically significant increase in total cholesterol and LDL cholesterol levels). Only the olanzapine group showed significant increases in triglyceride levels. After the 12-week study period, there were no significant changes in parameters involving glucose metabolism for any group.

CONCLUSIONS

Drug-naive patients experienced an extraordinary weight gain with first- and second-generation antipsychotics after the first 12 weeks of treatment. Significant increases in total cholesterol and LDL cholesterol levels are associated with the 3 treatments. Weight gain and metabolic disturbances induced by antipsychotics may increase the risk of developing cardiovascular disease.

Authors+Show Affiliations

Department of Psychiatry, Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18052567

Citation

Perez-Iglesias, Rocio, 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." The Journal of Clinical Psychiatry, vol. 68, no. 11, 2007, pp. 1733-40.
Perez-Iglesias R, Crespo-Facorro B, Amado JA, 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 Psychiatry. 2007;68(11):1733-40.
Perez-Iglesias, R., Crespo-Facorro, B., Amado, J. A., Garcia-Unzueta, M. T., Ramirez-Bonilla, M. L., Gonzalez-Blanch, C., Martinez-Garcia, O., & Vazquez-Barquero, J. L. (2007). A 12-week randomized clinical trial to evaluate metabolic changes in drug-naive, first-episode psychosis patients treated with haloperidol, olanzapine, or risperidone. The Journal of Clinical Psychiatry, 68(11), 1733-40.
Perez-Iglesias R, 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 Psychiatry. 2007;68(11):1733-40. PubMed PMID: 18052567.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A 12-week randomized clinical trial to evaluate metabolic changes in drug-naive, first-episode psychosis patients treated with haloperidol, olanzapine, or risperidone. AU - Perez-Iglesias,Rocio, AU - Crespo-Facorro,Benedicto, AU - Amado,Jose Antonio, AU - Garcia-Unzueta,Maria Teresa, AU - Ramirez-Bonilla,Maria Luz, AU - Gonzalez-Blanch,Cesar, AU - Martinez-Garcia,Obdulia, AU - Vazquez-Barquero,Jose Luis, PY - 2007/12/7/pubmed PY - 2008/1/4/medline PY - 2007/12/7/entrez SP - 1733 EP - 40 JF - The Journal of clinical psychiatry JO - J Clin Psychiatry VL - 68 IS - 11 N2 - OBJECTIVE: This study examined the main metabolic side effects induced by antipsychotic treatment in a cohort of first-episode drug-naive subjects. METHOD: A randomized, open-label, prospective clinical trial was conducted. Participants were 145 consecutive subjects included in a first-episode psychosis program (PAFIP) from February 2002 to February 2005, experiencing their first episode of psychosis (DSM-IV codes 295, 297, and 298), and never treated with antipsychotic medication. Patients were assigned to haloperidol, olanzapine, or risperidone treatment during 12 weeks. The main outcome measures were changes at 12 weeks in body weight; body mass index; and 12-hours-fasting morning levels of total cholesterol, tri-glycerides, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein cholesterol, glucose, homeostasis model assessment (HOMA) index, and insulin. RESULTS: At the endpoint, 128 patients were evaluated (88.3%). The mean doses were haloperidol = 4.2 mg/day, olanzapine = 12.7 mg/day, and risperidone = 3.6 mg/day. A significant weight gain was observed with the 3 antipsychotics: haloperidol = 3.8 (SD = 4.9) kg, olanzapine = 7.5 (SD = 5.1) kg, and risperidone = 5.6 (SD = 4.5) kg. Metabolic parameters showed a worsening lipid profile with the 3 treatments (statistically significant increase in total cholesterol and LDL cholesterol levels). Only the olanzapine group showed significant increases in triglyceride levels. After the 12-week study period, there were no significant changes in parameters involving glucose metabolism for any group. CONCLUSIONS: Drug-naive patients experienced an extraordinary weight gain with first- and second-generation antipsychotics after the first 12 weeks of treatment. Significant increases in total cholesterol and LDL cholesterol levels are associated with the 3 treatments. Weight gain and metabolic disturbances induced by antipsychotics may increase the risk of developing cardiovascular disease. SN - 1555-2101 UR - https://www.unboundmedicine.com/medline/citation/18052567/A_12_week_randomized_clinical_trial_to_evaluate_metabolic_changes_in_drug_naive_first_episode_psychosis_patients_treated_with_haloperidol_olanzapine_or_risperidone_ L2 - http://www.psychiatrist.com/jcp/article/pages/2007/v68n11/v68n1113.aspx DB - PRIME DP - Unbound Medicine ER -