Zhang Jinling, Chen Shu, Chen Jia, Zhang Handi, Rao Wen-Wang
Mental Health Center of Shantou University, Shantou, Guangdong, China.
The Fourth People's Hospital of Chengdu, Chengdu, Sichuan, China.
Front Psychiatry. 2023 May 12;14:1152953. doi: 10.3389/fpsyt.2023.1152953. eCollection 2023.
Topiramate (TPM) may reduce olanzapine (OLZ)-related weight gain and metabolism abnormalities in patients with schizophrenia. However, differences in the efficacy of OLZ-related weight gain and metabolism abnormalities between TPM and vitamin C (VC) are not clear. This study aimed to investigate whether TPM is more effective than VC in reducing OLZ-induced weight gain and metabolic abnormalities in patients with schizophrenia and explore their patterns.
This was a 12-week longitudinal comparison study in OLZ-treated patients with schizophrenia. Twenty-two patients who received OLZ monotherapy plus VC treatment (OLZ + VC group) was matched to 22 patients who received OLZ monotherapy plus TPM treatment (OLZ + TPM group). Body mass index (BMI) and metabolism indicators were measured at baseline and 12-weeks follow-up.
A significant difference in triglyceride (TG) levels at different time points (pre-treatment: = 7.89, = 0.008; 4-weeks treatment: = 13.19, = 0.001; 12-weeks treatment: = 54.48, < 0.001) was found. Latent profile analysis demonstrated that a 2-class model for OLZ + TPM group (high vs. low BMI in the first 4 weeks) and OLZ + VC group (high vs. low), respectively.
Our findings suggested that TPM could better mitigates OLZ-induced increase in TG levels. The trajectories of change also differed in all metabolic indexes over time between the two groups.
托吡酯（TPM）可能会减轻精神分裂症患者中与奥氮平（OLZ）相关的体重增加和代谢异常。然而，TPM与维生素C（VC）在减轻与OLZ相关的体重增加和代谢异常方面的疗效差异尚不清楚。本研究旨在调查TPM在减轻精神分裂症患者中OLZ诱导的体重增加和代谢异常方面是否比VC更有效，并探索其模式。
这是一项针对接受OLZ治疗的精神分裂症患者的为期12周的纵向比较研究。将22例接受OLZ单药治疗加VC治疗的患者（OLZ + VC组）与22例接受OLZ单药治疗加TPM治疗的患者（OLZ + TPM组）进行匹配。在基线和12周随访时测量体重指数（BMI）和代谢指标。
发现不同时间点的甘油三酯（TG）水平存在显著差异（治疗前： = 7.89， = 0.008；治疗4周： = 13.19， = 0.001；治疗12周： = 54.48， < 0.001）。潜在剖面分析表明，OLZ + TPM组（前4周高BMI与低BMI）和OLZ + VC组（高BMI与低BMI）分别有一个2类模型。
我们的研究结果表明，TPM可以更好地减轻OLZ诱导的TG水平升高。两组之间所有代谢指标随时间的变化轨迹也有所不同。
