ABSTRACT
To examine the efficacy and safety for metformin in treating antipsychotic-induced dyslipidemia. Methods: Two randomized placebo-controlled trials were included in the analysis. A total of 201 schizophrenia patients with dyslipidemia after treatment with an antipsychotic were collected, and the patients were divided into two groups: a 1 000 mg/d metformin group (n=103) and a placebo group (n=98). The clinical symptoms and metabolic indicators such as body weight, blood glucose, and blood lipids were assessed at baseline, the 12th week and the 24th week after treatment respectively. Results: After metformin treatment, the mean difference in the low-density lipoprotein cholesterol (LDL-C) value between the metformin group and the placebo group was from 0.16 mmol/L at baseline to -0.86 mmol/L at the end of the 24th week, which was decreased by 1.02 mmol/L (P<0.01). At the 24th week, the LDL-C was more than 3.37 mmol/L in 25.3% patients in the metformin group, which was significantly lower than that in the placebo group (64.8%) (P<0.01). Compared with the placebo group, there were significant changes in the weight, body mass index (BMI), insulin, insulin resistance index, total cholesterol and triglyceride, and high-density lipoprotein cholesterol (HDL-C) in the metformin group (all P<0.05). The treatment effects on weight and insulin resistance appeared at the 12th week and further improved at the 24th week, but the effects on improving dyslipidemia only significantly occurred at the end of the 24th week. Conclusion: The metformin treatment is effective in improving antipsychotic-induced dyslipidemia and insulin resistance, and the effect to reduce the antipsychotic-induced insulin resistance appears earlier than the effect to improve dyslipidemia.
Subject(s)
Humans , Antipsychotic Agents , Blood Glucose , Diabetes Mellitus, Type 2 , Double-Blind Method , Dyslipidemias , Drug Therapy , Hypoglycemic Agents , Metformin , Therapeutic UsesABSTRACT
OBJECTIVE@#To investigate the effect of ziprasidone and olanzapine on glucose and lipid metabolism in first-episode schizophrenia.@*METHODS@#A total of 260 schizophrenics were assigned randomly to receive ziprasidone or olanzapine for 6 weeks. The weight was measured at baseline, week 2, 4 and 6. Fasting blood glucose (FBS), fasting insulin, high-density lipoprotein (HDL), total-cholesterol (TC) and triglycerides (TG) were measured at baseline and the end of 6-week treatment. Low-density lipoprotein (LDL) was measured in some patients at baseline and the end of 6-week treatment. Body mass index (BMI) and insulin resistance index (IRI) were counted.@*RESULTS@#A total of 245 patients completed the trial, including 121 ziprasidone patients and 124 olanzapine patients. The average dose was 137.5 mg/d for ziprasidone and 19.5 mg/d for olanzapine. Patients treated with olanzapine had higher weight gain than those treated with ziprasidone [(4.55±3.37) kg vs (-0.83±2.05) kg, P<0.001]. After the treatment, FBS, fasting insulin, HDL, TC, TG, LDL and IRI levels were significantly increased in the olanzapine group (all P values<0.001 ). However, in the ziprasidone group, FBS decreased significantly and HDL and TG levels increased significantly after the 6-week treatment (all P values<0.05). The mean changes of FBS, fasting insulin, TC, TG, LDL and IRI were significantly different in the two groups (all P values<0.001).@*CONCLUSION@#Ziprasidone has less glucose and lipid metabolic effect for first-episode schizophrenia patients in short-term treatment. However, olanzapine induces weight gain and dysfunction of glucose and lipid metabolism significantly, which is associated with increased risk of complications. When the doctors choose antipsychotics in the clinic, they should consider the side effects of the medication.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Benzodiazepines , Therapeutic Uses , Blood Glucose , Lipid Metabolism , Olanzapine , Piperazines , Therapeutic Uses , Schizophrenia , Drug Therapy , Thiazoles , Therapeutic UsesABSTRACT
Objective To determine associations between weight gain induced by antipsychotic and the polymorphisms of HTR2C gene -759C/T and -697G/C,histamine-1 receptor gene,leptine gene -2548G/A,and adiponectin gene +276G/T and +45T/G.Methods In the casematched study,85 patients who gained more than 7％ of their pre-drug body weight served as the study group and another 85 patients who gained less than 7％ of their pre-drug body weight served as the control group.The ligation diction reaction technique was used to analyze the frequencies of the -759C/T and -697G/C polymorphism of the HTR2C gene,-2548A/G polymorphism of leptin gene,+ 276G/T and + 45T/G polymorphism of adiponectin gene and glu349asp polymorphism of H1 receptor gene.Results The presence of the -759C allele,-697G allele,-2548A allele and + 276G allele was significantly higher in the study group than that in the control group (P ＜ 0.05 ).Conclusion The -759C/T and -697G/C polymorphisms of the promoter region of 5HT2C receptor gene,-2548A/G polymorphisms of leptin gene and + 276G/T polymorphisms of adiponectin gene may be associated with the antipsychotic induced weight gain.The glu349asp polymorphisms of histamine-1 receptor gene is not associated with antipsychotic induced weight gain.