This retrospective study aimed to compare differences in hepatic enzyme elevation during treatment with either risperidone or olanzapine alone in patients with psychotic disorders. The charts were reviewed for six hundred and sixty-seven (667) inpatients with psychotic disorders who were treated with either risperidone (n=289) or olanzapine (n=145) alone at a university-affiliated hospital between 1998 and 2002. Frequencies of elevation greater than the reference level in any enzyme among aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphotase (ALP) were higher in the olanzapine-treated group (26.9%) than in the risperidone-treated group (14.2%) [odds ratio (OR)=2.225, 95% confidence interval (CI)=1.362-3.638, P=0.002]. Frequencies of elevation greater than the reference level in ALT were higher in the olanzapine-treated group than in the risperidone-treated group (OR=2.182, P=0.004), as were frequencies with two-fold (OR=3.064, P=0.017) and three-fold (OR=2.883, P=0.039) elevation. Recovery time was longer in the olanzapine-treated group than in the risperidone-treated group (P=0.0059), as was latency time (P=0.0044). These results suggest that there are potential differences in antipsychotic-associated hepatic enzyme alterations between risperidone and olanzapine treatment. Controlled, prospective studies should be conducted to identify the risk factors associated with an alteration in hepatic enzymes related to treatment with risperidone and olanzapine.
"In some studies, glutamic oxaloacetic transaminase levels increased in patients treated with risperidone, without significant clinical abnormalities. In contrast, in other studies, evidence of clinically significant increases in liver enzymes in children and adolescents during risperidone therapy was not found (Szigethy et al., 1999; Pae et al., 2005; Erdogan et al., 2008; Karaman et al., 2011). "
[Show abstract][Hide abstract] ABSTRACT: The aim of this prospective observational study was to verify the tolerability and safety profile of risperidone in a sample of antipsychotic-naive children/adolescent patients having a different psychiatric diagnosis. Twenty-two (mean age of 12±3.2) antipsychotic-naive patients who started therapy with risperidone were recruited. The assessment involved anthropometric data (weight, height, BMI, BMI z-score and BMI percentile), cardiovascular parameters (blood pressure and QTc interval) and blood tests (levels of glucose, triglycerides, total cholesterol, glutamic oxaloacetic and pyruvic transaminases, γ-glutamyl transferase, prolactin, free triiodothyronine, free thyroxine, thyroid-stimulating hormone, thyroglobulin, antithyroid peroxidase and antithyroglobulin). After an average follow-up of 6 months of risperidone therapy, a statistically significant increase in weight and body composition was observed. Furthermore, an increase in serum levels of prolactin was observed in 50% of patients. No other significant changes in metabolic and cardiovascular parameters were found. Although an increase in these parameters was detected, it remained in the normal range. This study suggests the use of specific protocols for monitoring children/adolescents treated with second-generation antipsychotics to manage the metabolic long-term complications and progression to more severe disease states.
International clinical psychopharmacology 05/2013; 28(4). DOI:10.1097/YIC.0b013e328362497b · 2.46 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Although the debate on whether new antipsychotics have advantages over the old neuroleptics has recently been refueled by the first publication of the Clinical Antipsychotic Trials of Intervention Effectiveness results, one of the new challenges in the pharmacological management of schizophrenia patients is to choose among the new-generation drugs.
Earlier work has compared these medications primarily to traditional antipsychotics and until very recently there was little published information on the relative efficacy/safety of new-generation antipsychotics.
This review covers studies wherein therapeutic effects and adverse events of these drugs in schizophrenia patients were compared in head-to-head studies and that were published in 2005. Information is clearly more homogenous on the safety profile side, while the available evidence still offers little help for the clinicians' daily struggles to find the optimally effective antipsychotic for an individual schizophrenia patient.
Current Opinion in Psychiatry 04/2006; 19(2):128-34. DOI:10.1097/01.yco.0000214336.21754.8c · 3.94 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Atypical antipsychotics commonly cause isolated asymptomatic increase in the aminotransferase levels. Among these atypical antipsychotics, mostly transient, asymptomatic increase in hepatic enzymes has been reported with olanzapine, however olanzapine rarely may induce a clinical and/or biological hepatic toxicity. The pathogenesis of olanzapine-associated hepatotoxicity is not well known and is mostly a transient phenomenon. However, substantial and lasting changes may occur and result in symptomatic hepatitis. In the following case report, we report on a 44-year-old female patient diagnosed as Bipolar Disorder Type I, whose liver enzyme levels increased ten fold of normal ranges during the third year of the olanzapine treatment and returned to the normal levels within three weeks after olanzapine discontinuation. Although significant liver enzyme elevations are uncommon during olanzapine treatment, based on reports of serious hepatotoxicity, controlled and longitudinal research are needed to learn side effects of this drug on liver. Clinicians should be aware of possible hepatotoxic effects of atypical antipsychotics and should monitor the liver enzyme levels whenever they feel necessary.
Progress in Neuro-Psychopharmacology and Biological Psychiatry 09/2006; 30(6):1163-6. DOI:10.1016/j.pnpbp.2006.03.014 · 3.69 Impact Factor
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