Журнал фармаконадзора

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Metabolic Alterations Associated With Antipsychotic Use–A Descriptive Study and Comparison between Haloperidol and Olanzapine in Schizophrenic and Bipolar Patients

Sérgio Luiz Prior, Antonio Ricardo de Toledo Gagliardi, Marcos Montani Caseiro and Pedro Luis Prior

Introduction: Antipsychotic drugs are essential to psychiatric health in many conditions, such as schizophrenia and bipolar disorder. However, they present several side effects, such as motor dystonia and “Parkinson-like” behavior (especially in first generation antipsychotics) and metabolic alterations leading to increased body weight, type 2 diabetes and dyslipidemias. Second generation antipsychotics are widely regarded as more damaging in metabolic side effects, though there are few studies comparing if first generation antipsychotics can provoke similar changes in metabolism. Methods: An observational-transversal-descriptive study was conducted in a total of 63 patients in use of their first generation (haloperidol–N=27) or second generation antipsychotic–olanzapine–N=36). Blood samples were collected to assess the following parameters–Fasting Glucose, HDL Cholesterol, LDL Cholesterol, Triglycerides and Basal Insulin. Anthropometric measurements of abdominal and neck circumference, as well as weight were also taken and compared between both groups. Statistical analyses: If variables were considered of normal distribution, the Student t-test and variance analyses (ANOVA) were performed to test for significant differences between groups. If samples were considered non-parametric, U Mann-Whitney test, Kruskal-Wallis test, Qui-square for extensive table, or Fish’s test were utilized. Statistical significance was considered 5% on all analyzes (p<0.05). Results: There were no statistically significant differences between both groups using either first and second generation antipsychotics., in relation to anthropometric measurements (abdominal circumference measurements p=0.56, U Mann-Whitney test), metabolic status (HOMA index p=0.12 , HDL cholesterol p=0.27, basal glycemia p=0.08 , BMI p=0.51, triglycerides p=0.12, Chi-square for extensive tables). Discussion: Metabolic alterations occurred in both groups, which support the literature findings which show a high prevalence of metabolic alteration in antipsychotic medication users.