Zahan T, Akhter N, Mullick M S I, Dewan Z F
Bangladesh Med Res Counc Bull. 2015 Dec;41(3):144-150. doi: 10.3329/bmrcb.v41i3.29972.
The second generation antipsychotic agents, although exhibit superior safety profile, is associated with metabolic adverse effects including weight gain, diabetes mellitus and hyperlipidaemia. These adverse effects are not only the risk factors for cardiovascular disease and diabetes mellitus but may also impair patient's adherence to treatment. However, different member of second generation antipsychotics differ. in their extent of metabolic adverse effects. The aim of the study was to evaluate the association between olanzapine, risperidone or quetiapine treatment and body mass index, blood pressure, diabetes mellitus and hyperlipidaemia in patients with Schizophrenia and Bipolar Disorder. Forty-four cases of Schizophrenia and Bipolar Disorder diagnosed with DSM-IV criteria were selected according to inclusion and exclusion criteria. Body weight, body mass index and blood pressure were measured at baseline, at the end of 4th, 8th and 12th weeks of treatment. Blood samples were collected to measure blood glucose and serum lipid profile at baseline and at the end of 4th, 8th and 12th weeks in the study group receiving treatment (olanzapine 20-30 mg/day, risperidone 4-16 mg/day and quetiapine 300-800 mg/day) after overnight fasting. Therapeutic use of olanzapine and risperidone in Schizophrenia and Bipolar Disorder for a period of 4th, 8th and 12th weeks was associated with significant increase in body weight and body mass index. Quetiapine did not cause significant changes in body weight and body mass index after 4 and 8 weeks. However, after 12 weeks treatment, body mass index increased significantly. Olanzapine, risperidone and quetiapine increased the blood glucose level significantly after 8 and 12 weeks treatment. Olanzapine and risperidone elevated the serum cholesterol, triglyceride and low density lipoprotein levels significantly after 4, 8 and 12 weeks. But quetiapine showed no significant change in lipid profile. However, olanzapine and risperidone significantly increased triglyceride level after 8 and 12 weeks. Amongst three drugs, quetiapine treatment increased high density lipoprotein level. Our study revealed that quetiapine treatment is associated with less risk of dyslipidaemia.
第二代抗精神病药物虽然具有更好的安全性，但与包括体重增加、糖尿病和高脂血症在内的代谢不良反应相关。这些不良反应不仅是心血管疾病和糖尿病的危险因素，还可能损害患者对治疗的依从性。然而，第二代抗精神病药物的不同成员在代谢不良反应的程度上存在差异。本研究的目的是评估奥氮平、利培酮或喹硫平治疗与精神分裂症和双相情感障碍患者的体重指数、血压、糖尿病和高脂血症之间的关联。根据纳入和排除标准，选取了44例符合DSM-IV标准的精神分裂症和双相情感障碍患者。在基线、治疗第4、8和12周结束时测量体重、体重指数和血压。在接受治疗（奥氮平20 - 30毫克/天、利培酮4 - 16毫克/天和喹硫平300 - 800毫克/天）的研究组中，在隔夜禁食后，于基线以及治疗第4、8和12周结束时采集血样，测量血糖和血脂谱。在精神分裂症和双相情感障碍中，奥氮平和利培酮治疗4、8和12周与体重和体重指数显著增加相关。喹硫平在治疗4周和8周后未引起体重和体重指数的显著变化。然而，治疗12周后，体重指数显著增加。奥氮平、利培酮和喹硫平在治疗8周和12周后显著提高血糖水平。奥氮平和利培酮在治疗4、8和12周后显著提高血清胆固醇、甘油三酯和低密度脂蛋白水平。但喹硫平的血脂谱无显著变化。然而，奥氮平和利培酮在治疗8周和12周后显著提高甘油三酯水平。在三种药物中，喹硫平治疗可提高高密度脂蛋白水平。我们的研究表明，喹硫平治疗与血脂异常风险较低相关。
