The Effects of Novel Antipsychotics on Glucose and Lipid Levels
J Clin Psychiatry 2002;63(10):856-865
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: The novel antipsychotics are
extensively used based on their favorable extrapyramidal side
effect profiles. However, accumulating evidence suggests that
these agents, particularly clozapine and olanzapine, have serious
side effects of their own, including weight gain and elevated
glucose and triglyceride levels. The goal of this study is to
compare the effects of novel antipsychotics clozapine,
olanzapine, risperidone, and quetiapine and typical
antipsychotics haloperidol and fluphenazine on glucose and lipid
Method: The charts of 590 patients were
retrospectively reviewed. Of those, 215 patients had adequate
laboratory data for inclusion. Glucose and lipid level data from
21/2 years before and after initiation of
the target antipsychotic were included. Covariates, including
patients' age, the duration of antipsychotic treatment, other
medications that may affect glucose or lipid levels, and the
initial laboratory values, were controlled for in the analyses.
Results: Glucose levels were increased from
baseline for patients treated with clozapine, olanzapine, and
haloperidol. There were statistically and clinically significant
differences among the medications' effects on lipid profiles (p
< .05). Those receiving clozapine and olanzapine demonstrated
statistically significant increases in triglyceride levels
compared with the other groups. Over one third of patients
treated with any of the novel antipsychotics had clinically
meaningful triglyceride elevations.
Conclusion: It has been shown that novel
antipsychotics are associated with weight gain. This risk factor
along with others, such as elevated glucose and triglyceride
levels, compounds the risk for coronary artery disease. Routine
monitoring of glucose and lipid levels during treatment with
novel antipsychotics should be advocated.