Changes in Metabolic Parameters With Switching to Aripiprazole From Another Second-Generation Antipsychotic: A Retrospective Chart Review

Ronald D. Spurling, M.D.; J. Steven Lamberti, M.D.; David Olsen, Ph.D., R.Ph.; Xin Tu, Ph.D.; and Wan Tang, Ph.D.

Objective: This is a retrospective chart review of psychiatric outpatients switched to aripiprazole from another second-generation antipsychotic (SGA) examining whether metabolic parameters improved after the switch.

Method: Twenty-four psychiatric outpatients who had been switched to aripiprazole from another SGA were evaluated. Data were collected from October 6, 2004, until February 25, 2005, through review of medical records. Laboratory values and physical data were extracted to assess levels of fasting blood glucose, triglycerides, total cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL), and weight.

Results: After switching to aripiprazole, total cholesterol was significantly decreased, with a mean (SD) difference of -28.8 (32.1) mg/dL (p = .001), and LDL was significantly decreased, with a mean (SD) difference of -20.75 (21.7) mg/dL (p = .0017). Weight was also significantly decreased, with a mean (SD) difference of -11.7 (16.6) lb (p = .003). There were no significant differences in HDL, triglycerides, or fasting blood glucose. When a subgroup of 15 patients switched from olanzapine to aripiprazole was examined separately, these changes were even more robust. In this subgroup, total cholesterol was significantly decreased, with a mean (SD) difference of -32.0 (35.6) mg/dL (p = .01). LDL was significantly decreased, with a mean (SD) difference of -21.6 (24.7) mg/dL (p = .011), and weight was significantly decreased, with a mean (SD) difference of -16.7 (14.7) lb (p < .001). Changes in total cholesterol, LDL, and HDL were not significantly different between subjects taking lipid-lowering medications and those not taking them.

Conclusion: Psychiatric outpatients switched to aripiprazole from another SGA showed a decrease in weight, total cholesterol, and LDL. Switching to aripiprazole, when clinically indicated, may lead to improvement in metabolic parameters associated with cardiovascular disease.

(J Clin Psychiatry 2007;68:406-409)

Received July 6, 2006; accepted Nov. 16, 2006. From the Department of Psychiatry (all authors) and the Department of Biostatistics (Dr. Tu), University of Rochester, Strong Memorial Hospital, Rochester, N.Y.

Dr. Lamberti has received grant/research support from Pfizer and Bristol-Myers Squibb and has served on speakers/advisory boards for Eli Lilly. Drs. Spurling, Olsen, Tu, and Tang report no financial or other relationship relevant to the subject of this article.

Corresponding author and reprints: Ronald D. Spurling, M.D., 300 Crittenden Blvd., University of Rochester, Strong Memorial Hospital, Rochester, NY 14642 (e-mail: ronald_spurling@urmc.rochester.edu).