Effects of olanzapine on lipid abnormalities in elderly psychotic patients.
BACKGROUND
Recently concern regarding the cause or worsening of diabetes mellitus by some of the second-generation antipsychotics and their adverse affects on lipid metabolism has caused growing concern amongst physicians and patients. This study aims to assess these effects in elderly patients with schizophrenia.


METHODS
In a prospective 6-month follow-up study of elderly inpatients experiencing an acute psychotic exacerbation and exposed to olanzapine for the first time, patients underwent physical and psychiatric assessments including: routine laboratory tests (including serum cholesterol and triglycerides levels), and bodyweight and clinical rating scale measurement. All tests and evaluations were performed at baseline and at the end of study.


RESULTS
Twenty-one elderly patients with schizophrenia (15 women and six men) mean age 71.7 +/- 8.2 years were included. All were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (4th edition) as patients with schizophrenia or schizoaffective disorder. Mean duration of olanzapine treatment was 289 days (SD +/- 139) and the mean olanzapine dosage at the end of the study was 12.9 mg/day. At the end of the study, no significant change from baseline serum lipid levels were found for triglycerides (paired differences = -12.8 [SD +/- 38.5], 95% CI -30.3 to +4.7, t = -1.5, df = 20, p = 0.143) or cholesterol (paired differences = -9.0 [SD +/- 43.5], 95% CI = -28.8 to +10.8, t = -0.95, df = 20, p = 0.355).


CONCLUSIONS
The association between olanzapine exposure and lipid abnormalities may not hold true for older patients. Larger studies with elderly patients are needed to support the present report.
Barak
Yoram
Y
Psychiatric Department, Abarbanel Mental Health Center, Bat-Yam, Israel. mdybarak@netvision.net.il
Aizenberg
Dov
D
D000368:Aged; D000369:Aged, 80 and over; D001569:Benzodiazepines / Q000009:adverse effects* / Q000627:therapeutic use; D002784:Cholesterol / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000188:drug therapy; D012559:Schizophrenia / Q000188:drug therapy*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D014280:Triglycerides / Q000097:blood
D001569:Benzodiazepines; D002784:Cholesterol; D008055:Lipids; D000077152:Olanzapine; D017367:Selective Serotonin Reuptake Inhibitors; D014280:Triglycerides