A Retrospective Comparison of Weight, Lipid, and Glucose Changes Between Risperidone- and Olanzapine-Treated Inpatients: Metabolic Outcomes After 1 Year
J Clin Psychiatry 2002;63:425-433
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Metabolic side effects have been
increasingly noted during therapy with novel
antipsychotics, but there is a dearth of comprehensive
comparative data in this area. The goal of this
retrospective study was to examine the changes in weight
parameters, fasting glucose, and fasting lipids in
long-term inpatients treated with either risperidone or olanzapine.
Method: A retrospective study was performed
by reviewing charts of patients at Oregon State
Hospital, Salem, who were treated during July and August
1999, comparing metabolic outcomes during the first year
of therapy with either risperidone or olanzapine.
Data were analyzed also by age, sex, and concurrent use
of lithium or valproate. Included for analysis were
patients at least 18 years old with baseline weights
obtained within 3 weeks of drug initiation, and
baseline fasting triglycerides, cholesterol, and glucose
obtained within 3 months prior to drug initiation and at 1 year
of treatment (±4 weeks). The patients meeting these
criteria in each drug cohort (risperidone, N=47;
olanzapine, N=47) included 1 patient with diagnosed
diabetes mellitus prior to onset of treatment.
Results: Among those patients under 60 years
old, olanzapine patients (N=37) experienced
significantly greater increases at 1 year in all metabolic
parameters than the risperidone group (N=39), except for
weight variables: triglycerides +104.8 mg/dL (olanzapine)
versus +31.7 mg/dL (risperidone) (p=.037);
cholesterol +30.7 mg/dL (olanzapine) versus +7.2 mg/dL
(risperidone) (p=.004); glucose +10.8 mg/dL
(olanzapine) versus +0.74 mg/dL (risperidone) (p=.030).
Patients under 60 years of age with concurrent use of lithium
or valproate were associated with greater weight gain
in both drug groups, but this difference was
statistically significant only for the olanzapine cohort.
Neither weight change nor use of lithium or valproate was
associated with increases in glucose or lipids
among those under 60 years old for either drug.
Conclusion: Olanzapine therapy is associated
with significantly greater increases in fasting glucose
and lipid levels for nongeriatric adult patients than
risperidone, and the increases are not correlated with
changes in weight parameters. Appropriate monitoring of
fasting glucose and serum lipid levels should be
considered during extended treatment with atypical antipsychotics.