Olanzapine Induces Insulin Resistance: Results From A Prospective Study
J Clin Psychiatry 2003;64:1436-1439
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: The aim of this study was to compare
glucose metabolism in patients with schizophrenia receiving
olanzapine with that in control subjects.
Method: We conducted a prospective, controlled,
open study comparing body weight, fat mass, and indices of
insulin resistance/sensitivity in 10 olanzapine-treated patients
with ICD-10 schizophrenia (olanzapine dose range, 7.5-20 mg/day)
with those of a group of 10 mentally and physically healthy
volunteers. Weight, fat mass, and indices of insulin
resistance/sensitivity were assessed over individual 8-week
observation periods from November 1997 to October 1999.
Results: Fasting serum glucose and fasting serum
insulin increased significantly in the olanzapine-treated
patients (p = .008 for glucose and p = .006 for insulin). The
homeostasis model assessment (HOMA) index for beta cell function
did not change significantly in the olanzapine-treated patients,
whereas the HOMA index for insulin resistance did increase (p =
.006). In the control group, these parameters were stable. A
significant increase in body weight (p = .001) and body fat (p =
.004) was seen in patients treated with olanzapine, while the
control group showed no significant changes.
Conclusion: This study indicates that the
disturbances in glucose homeostasis during antipsychotic
treatment with olanzapine are mainly due to insulin resistance.
However, beta cell function remains unaltered in
olanzapine-treated patients. We conclude that treatment with some
second-generation antipsychotic drugs may lead to insulin