No effect of atypical antipsychotic drugs on weight gain and risk of developing type II diabetes or lipid abnormalities among nursing home elderly patients with Alzheimer's disease
ABSTRACT Weight gain and the risk of developing alterations in lipid and glucose metabolism are possible side effects of atypical antipsychotic therapy in young and adult patients. The objective of this study was to examine whether elderly patients with Alzheimer's disease (AD) gain weight or develop disturbances in lipid and glucose metabolism while being treated with atypical antipsychotic drugs.
This retrospective study identified 36 out of 99 patients (mean age: 75.4+/-7.1, 27 female, 9 males) who were taking risperidone (N=9, mean dosage: 1.42+/-0.49 mg/day), olanzapine (N=17: 4.42+/-1.10 mg/day), and quetiapine (N=10: 75+/-27 mg/day) over a 12 months period. Anthropometric parameters, mini nutritional assessment (MNA), total, HDL and LDL cholesterol, triglycerides, glycaemia were assessed at baseline (T0) and 12 (T1) months.
Body weight (BMI=23+/-5 vs 23+/-5), MNA score (21+/-4 vs 21+/-4), blood glucose (5.7+/-2 vs 4.9+/-0.9 mmol/L) or total cholesterol (4.9+/-1.1 vs 4.3+/-0.7 mmol/L), HDL cholesterol (1.3+/-0.3 vs 1.1+/-0.3 mmol/L), LDL cholesterol (3.3+/-0.7 vs 3 +/- 0.4 mmol/L), triglycerides (1.1+/-0 vs 1+/-0.3 mmol/L) did not reveal treatment-induced changes in the patients evaluated (T0 vs T1).
These results suggest that the treatment with low-dose of atypical antipsychotic drugs is not associated with weight gain or increase the risk of developing type II diabetes or abnormalities of lipid metabolism among elderly patients with AD, who were residing in long-term nursing home.
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ABSTRACT: With an increase in the global prevalence of dementia, there is also an increase in behavioural and psychological symptoms of dementia (BPSD) for which antipsychotic drugs are often used. Despite several safety warnings on antipsychotic use in dementia, there is little evidence to support the efficacy of antipsychotics in individual BPSD symptoms or to evaluate the drug safety profile by individual antipsychotic drug. There is emerging but scarce evidence that suggests an inter-drug variability between antipsychotic safety outcomes in BPSD. The objective of this review was to examine the existing literature on antipsychotic drug use in dementia patients; in particular to see whether inter-drug differences regarding antipsychotic safety were reported. A literature search was conducted for observational studies published in the English language from 2004 to 2014 that reported the risk of all-cause mortality, cerebrovascular events, pneumonia and other outcomes such as hip/femur fracture, deep vein thrombosis (DVT) and hyperglycaemia. Six of 16 mortality studies (38 %), 7 of 28 stroke studies (25 %), 1 of 6 pneumonia (17 %) studies and 2 of 6 fracture studies (33 %) investigated inter-drug safety outcomes in elderly patients/dementia patients, while to our knowledge, there are no studies investigating the inter-drug variation of deep-vein thrombosis and hyperglycaemia risk. The results of the observational studies provide mixed results on the safety of antipsychotics in BPSD but it is clear that there are differences between the safety profiles of antipsychotic drugs. Robust evidence of such inter-drug variability could significantly improve patient safety as antipsychotics become more targeted to clinical risk factors.Drug Safety 05/2014; 37(7). DOI:10.1007/s40264-014-0170-y · 2.62 Impact Factor
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ABSTRACT: Background. Concern exists about safety of risperidone in glucose and lipid metabolism as well as cerebrovascular mortality. Our aim is to evaluate the safety of low-dose risperidone in elderly dementia patients with associated behavioral disturbances on glucose, serum lipids and cerebrovascular mortality. Material and methods. Thirty-one patients entered the study. Fasting glucose, total cholesterol, LDL, HDL, BMI, waist circumference, and triglycerides were measured at baseline and after 3 months. Mortality was reported after 6 months of starting the study. Risk factors for cerebrovascular disease were reported. A control group with 30 subjects was included. Results. Eighteen women and 13 men were included. Mean age was 80.6 years. After analyzing the different variables no significant differences between baseline and after 3 months of follow-up were found. During the study seven (22.58%) patients died, one from stroke. The most frequent associated cerebrovascular risk factors were smoking history, valvular heart disease and atrial fibrillation. Conclusion. In our study, low-dose risperidone administered in patients with behavioral symptoms associated dementia does not affect significantly the lipid profile, fasting glucose, BMI or waist circumference and is not associated with an increased risk for cerebrovascular mortality.International Journal of Psychiatry in Clinical Practice 07/2009; 12(3):196-201. DOI:10.1080/13651500701830238 · 1.31 Impact Factor
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ABSTRACT: Objectives. Atypical anti-psychotic drugs are new medications proposed for treating psychotic disorders. This study was designed to investigate the metabolic (blood sugar and lipid) and adverse effects of olanzapine and risperidone in psychotic patients. Methods. In this randomized double-blinded clinical trial, psychotic patients were randomly categorized to be treated with olanzapine or risperidone. All the subjects were initially assessed for blood sugar and lipids, and, where normal, were included. Blood sugar and lipids measurements were performed for all subjects at 1 week and after 3 months the initiation of therapy, and they were assessed for other complications as well. The data were subsequently analyzed using SPSS software. Results. The levels of blood sugar, cholesterol, and triglyceride rose significantly after 1 week and 3 months of therapy (P<0.001); the difference in rise of cholesterol and triglyceride in the olanzapine and the risperidone groups was significant (P<0.001), whereas the difference in blood sugar rise was not significant (P>0.05). Other complications including restlessness, impotence, weight gain, edema and drowsiness were significantly different between the two groups. Conclusion. According to the study findings, we recommend more caution in the application of atypical antipsychotic drugs in high risk patients.International Journal of Psychiatry in Clinical Practice 07/2009; 12(4):299-302. DOI:10.1080/13651500802155337 · 1.31 Impact Factor