Metabolic profiles of second-generation antipsychotics in early psychosis: findings from the CAFE study
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Authors
Patel, Jayendra K.Buckley, Peter F.
Woolson, Sandra
Hamer, Robert M.
McEvoy, Joseph P.
Perkins, Diana O.
Lieberman, Jeffrey A.
UMass Chan Affiliations
Department of PsychiatryDocument Type
Journal ArticlePublication Date
2009-06-01Keywords
AdolescentAdult
Antipsychotic Agents
Body Mass Index
Body Weight
Dose-Response Relationship, Drug
Double-Blind Method
Female
Follow-Up Studies
Humans
Male
Mental Disorders
Metabolic Diseases
Metabolome
Psychiatric Status Rating Scales
Sex Factors
Time Factors
Young Adult
Psychiatry
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Show full item recordAbstract
OBJECTIVE: To further define the metabolic profiles of second-generation antipsychotics during the treatment of young patients with early psychosis, with a view to better inform prescribing clinicians. METHOD: Weight, body mass index (BMI), glucose, and serum lipids were measured in the 52-week Comparison of Atypicals for First Episode (CAFE) study, in which olanzapine, quetiapine, and risperidone were evaluated, and whose primary outcomes have been reported elsewhere. These metabolic data were analyzed using a mixed random coefficients model for continuous longitudinal measures and a logistic regression model for categorical responses. RESULTS: Of the 400 patients recruited, 31% were overweight and 18% were obese at baseline, and 17 (4.3%) patients met criteria for metabolic syndrome. After 12 and 52 weeks of treatment, weight gain >or=7% from baseline was reported in 29.2% and 50.0% of quetiapine-treated patients, 59.8% and 80.0% of olanzapine-treated patients, and 32.5% and 57.6% of risperidone-treated patients, respectively. Weight gain after 12 and 52 weeks of treatment was estimated as [Least Squares Mean (SE)] 15.6 (+/-1.1) and 24.2 (+/-1.9) lb for olanzapine, 8.6 (+/-1.1) and 14.0 (+/-1.9) lb with risperidone and 7.9 (+/-1.1) and 12.1 (+/-1.8) lb for quetiapine respectively. In women, greater weight gain occurred during risperidone treatment compared with quetiapine treatment. By week 52, increases in BMI >or=1 unit occurred with significantly higher frequency in olanzapine-treated patients compared with quetiapine- or risperidone-treated patients. By 52 weeks, treatment-emergent metabolic syndrome was reported in 51 individuals (13.4% of the total population), of whom 22 were receiving olanzapine, 18 quetiapine, and 11 risperidone. Risperidone was associated with the smallest elevations in triglyceride and total cholesterol levels. CONCLUSION: Weight gain and metabolic syndrome occur commonly even in young patients receiving antipsychotic treatment for early psychosis. Targeted interventions are therefore warranted from the onset of antipsychotic therapy.Source
Schizophr Res. 2009 Jun;111(1-3):9-16. Epub 2009 Apr 26. Link to article on publisher's siteDOI
10.1016/j.schres.2009.03.025Permanent Link to this Item
http://hdl.handle.net/20.500.14038/45989PubMed ID
19398192Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1016/j.schres.2009.03.025