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Aripiprazole added to overweight and obese olanzapine-treated schizophrenia patients.
J Clin Psychopharmacol. 2009 Apr; 29(2):165-9.JC

Abstract

Olanzapine treatment has been associated with clinically meaningful weight increases, hypertriglyceridemia, insulin resistance, and diabetes mellitus. There are few options for olanzapine responders who fail other antipsychotic agents. Aripiprazole is a potent (high-affinity) partial agonist at D2 and 5-HT1A receptors and a potent antagonist at 5-HT2A receptor and is associated with less weight gain than olanzapine. We report the results of a 10-week placebo-controlled, double-blind crossover study that examined 15 mg/d aripiprazole's effects on weight, lipids, glucose metabolism, and psychopathology in overweight and obese schizophrenia and schizoaffective disorder subjects treated with a stable dose of olanzapine. During the 4 weeks of aripiprazole treatment, there were significant decreases in weight (P = 0.003) and body mass index (P = 0.004) compared with placebo. Total serum cholesterol (P = 0.208), high-density lipoprotein cholesterol (HDL-C; P = 0.99), HDL-2 (P = 0.08), HDL-3 (P = 0.495), and low-density lipoprotein cholesterol (P = 0.665) did not change significantly comparing aripiprazole treatment to placebo treatment. However, total serum triglycerides (P = 0.001), total very low-density lipoprotein cholesterol (VLDL-C; P = 0.01), and VLDL-1C and VLDL-2C (P = 0.012) decreased significantly during the aripiprazole treatment phase. The VLDL-3C tended lower during aripiprazole, but the decrease was not significant (P = 0.062). There was a decrease in C-reactive protein comparing aripiprazole treatment to placebo, although it did not reach significance (P = 0.087). The addition of aripiprazole to a stable dose of olanzapine was well tolerated and resulted in significant improvements on several outcome measures that predict risk for medical morbidity.

Authors+Show Affiliations

Schizophrenia Program, Massachusetts General Hospital, Boston, MA, USA. dchenderson@partners.orgNo affiliation info availableNo affiliation info availableNo 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

19512978

Citation

Henderson, David C., et al. "Aripiprazole Added to Overweight and Obese Olanzapine-treated Schizophrenia Patients." Journal of Clinical Psychopharmacology, vol. 29, no. 2, 2009, pp. 165-9.
Henderson DC, Fan X, Copeland PM, et al. Aripiprazole added to overweight and obese olanzapine-treated schizophrenia patients. J Clin Psychopharmacol. 2009;29(2):165-9.
Henderson, D. C., Fan, X., Copeland, P. M., Sharma, B., Borba, C. P., Boxill, R., Freudenreich, O., Cather, C., Evins, A. E., & Goff, D. C. (2009). Aripiprazole added to overweight and obese olanzapine-treated schizophrenia patients. Journal of Clinical Psychopharmacology, 29(2), 165-9. https://doi.org/10.1097/JCP.0b013e31819a8dbe
Henderson DC, et al. Aripiprazole Added to Overweight and Obese Olanzapine-treated Schizophrenia Patients. J Clin Psychopharmacol. 2009;29(2):165-9. PubMed PMID: 19512978.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Aripiprazole added to overweight and obese olanzapine-treated schizophrenia patients. AU - Henderson,David C, AU - Fan,Xiaoduo, AU - Copeland,Paul M, AU - Sharma,Bikash, AU - Borba,Christina P, AU - Boxill,Ryan, AU - Freudenreich,Oliver, AU - Cather,Corinne, AU - Evins,A Eden, AU - Goff,Donald C, PY - 2009/6/11/entrez PY - 2009/6/11/pubmed PY - 2009/8/19/medline SP - 165 EP - 9 JF - Journal of clinical psychopharmacology JO - J Clin Psychopharmacol VL - 29 IS - 2 N2 - Olanzapine treatment has been associated with clinically meaningful weight increases, hypertriglyceridemia, insulin resistance, and diabetes mellitus. There are few options for olanzapine responders who fail other antipsychotic agents. Aripiprazole is a potent (high-affinity) partial agonist at D2 and 5-HT1A receptors and a potent antagonist at 5-HT2A receptor and is associated with less weight gain than olanzapine. We report the results of a 10-week placebo-controlled, double-blind crossover study that examined 15 mg/d aripiprazole's effects on weight, lipids, glucose metabolism, and psychopathology in overweight and obese schizophrenia and schizoaffective disorder subjects treated with a stable dose of olanzapine. During the 4 weeks of aripiprazole treatment, there were significant decreases in weight (P = 0.003) and body mass index (P = 0.004) compared with placebo. Total serum cholesterol (P = 0.208), high-density lipoprotein cholesterol (HDL-C; P = 0.99), HDL-2 (P = 0.08), HDL-3 (P = 0.495), and low-density lipoprotein cholesterol (P = 0.665) did not change significantly comparing aripiprazole treatment to placebo treatment. However, total serum triglycerides (P = 0.001), total very low-density lipoprotein cholesterol (VLDL-C; P = 0.01), and VLDL-1C and VLDL-2C (P = 0.012) decreased significantly during the aripiprazole treatment phase. The VLDL-3C tended lower during aripiprazole, but the decrease was not significant (P = 0.062). There was a decrease in C-reactive protein comparing aripiprazole treatment to placebo, although it did not reach significance (P = 0.087). The addition of aripiprazole to a stable dose of olanzapine was well tolerated and resulted in significant improvements on several outcome measures that predict risk for medical morbidity. SN - 1533-712X UR - https://www.unboundmedicine.com/medline/citation/19512978/Aripiprazole_added_to_overweight_and_obese_olanzapine_treated_schizophrenia_patients_ L2 - https://doi.org/10.1097/JCP.0b013e31819a8dbe DB - PRIME DP - Unbound Medicine ER -