Hyperlipidemia following treatment with antipsychotic medications
ABSTRACT This study attempted to estimate the relative risk of developing hyperlipidemia after treatment with antipsychotics in relation to no antipsychotic treatment.
A matched case-control analysis was performed with pharmacy and claims data from California Medicaid (Medi-Cal). Patients were excluded if they were treated for medical disorders or prescribed medications known to increase their risk of hyperlipidemia. Cases were ages 18 to 64 years with schizophrenia, major depression, bipolar disorder, or other affective psychoses and incident hyperlipidemia. Cases were matched to up to six control subjects by age, sex, race, and psychiatric diagnosis. Both groups were prescribed either no antipsychotic medication or had two or more prescriptions for one and only one antipsychotic medication during the 60 days prior to the first indication of hyperlipidemia (cases) or matched index date (controls) in the billing record. Conditional logistic regressions were used to derive odds ratios and 95% confidence intervals (95% CIs) of each antipsychotic medication in relation to no antipsychotic medication.
A total of 13,133 incident cases of hyperlipidemia were matched to 72,140 control subjects. As compared with no antipsychotic medication, treatment with clozapine (odds ratio: 1.82, 95% CI: 1.61-2.05), risperidone (odds ratio: 1.53, 95% CI: 1.43-1.64), quetiapine (odds ratio: 1.52, 95% CI: 1.40-1.65), olanzapine (odds ratio: 1.56, 95% CI: 1.47-1.67), ziprasidone (odds ratio: 1.40, 95% CI: 1.19-1.65), and first-generation antipsychotics (odds ratio: 1.26, 95% CI: 1.14-1.39), but not aripiprazole (odds ratio: 1.19, 95% CI: 0.94-1.52) was associated with a significant increase in risk of incident hyperlipidemia.
These findings suggest that most commonly prescribed antipsychotic medications increase the risk of developing hyperlipidemia in patients with schizophrenia or mood disorders.
- SourceAvailable from: Bruce Imbert
Alcohol and Alcoholism 04/2013; 48(4). DOI:10.1093/alcalc/agt033
- "To our knowledge, there is no proven link between the prescription of baclofen and an increased blood level of triglycerides. Risperidone, and more generally atypical antipsychotics, widely used in schizophrenia and bipolar disorder, is known to cause an increase in triglycerides (Weinbrenner et al., 2009), but this increase is usually small and below 2 g/l (Olfson et al., 2006). We report here an original case of a patient treated with atypical antipsychotic (risperidone) for a type 1 bipolar disorder and high-dose baclofen (HDB) for alcohol dependence who presented a rapid and severe elevation of his blood level of triglycerides. "
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- "If, from the perspective of clinical efficiency, conventional antipsychotics lived up to expectations, side effects and long-time monitoring leaded these substances in the second-line therapy of psychotic disorders  . After 1990, the issue of second-generation antipsychotics (atypical) was considered a true revolution in psychopharmacology. "
ABSTRACT: The issue of antipsychotics in psychiatry constituted a revolution at the time. The firsts, starting with chlorpromazine represent the conventional antipsychotics, in the last decades there was a new generation of antipsychotics, atypical, which improved the results in treating psychoses. Because, as any drug, it may have adverse effects we aimed an experimental study on rats to observe the toxic potential on liver of both generations of antipsychotics. From the first generation we used chlorpromazine, haloperidol and haloperidol decanoate and from the second, aripiprazole and risperidone. Results of the study show an increased toxicity of chlorpromazine and diminished among the others, without being the same for every drug.Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie 01/2011; 52(1 Suppl):465-9.
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- "Nevertheless, weight gain may be a misleading factor in the estimation of RIS-induced dyslipidemia. In a recent matched case– control analysis of a large sample of psychotic patients (Olfson et al., 2006), both Quet and RIS were found significantly associated with new-onset hyperlipidemia. Interestingly, RIS monotherapy has been shown to worsen lipid metabolism in long-term treated patients (Murashita et al., 2007). "
ABSTRACT: Beside the therapeutic improvement over first-generation antipsychotics, the fact that prescription of atypical agents is also associated to the emergence of severe metabolic derangement in patients is not a mystery anymore. Body weight gain, dyslipidemia, adiposity, impaired glucose homeostasis, insulin and leptin resistance and new-onset type II diabetes are all part of a syndromic cluster of vast medical concern. Thus, clinical reports and rodent models of atypical antipsychotic-associated metabolic impairment have growth in parallel as separate territories. This review focuses on the attempt to take a snapshot of the present developing moment and to describe to what extent clinical data are reflected by the findings derived from animal studies. This aim is pursued through different steps that, starting from the criteria necessary to characterize the "atypicality" of atypical drugs, then explore the consistency among clinical and animal-based data. The endpoint of this survey consists in the analysis of the potential mechanisms underlying the metabolic derangement induced by this class of drugs. It is, indeed, our opinion that some atypical antipsychotics should be viewed as potent obesogenic factors that can be exploited as valuable tools to shed light into the elusive dilemma of obesity. For this reason, recently identified obesogenic and diabetogenic mechanisms are the background on which the present work is built and some novel forthcoming lines of investigation suggested.Pharmacology [?] Therapeutics 09/2010; 127(3):210-51. DOI:10.1016/j.pharmthera.2010.04.008