Development of an atherogenic metabolic risk factor profile associated with the use of atypical antipsychotics.
BACKGROUND
It is important to assess cardiovascular risk factors to properly verify the potential consequences of atypical antipsychotic-related weight gain. The objective of the present study was to evaluate whether 2 atypical antipsychotics differ regarding their impact on the cardiovascular disease risk profile compared with a reference group.


METHODS
We conducted a cross-sectional, multicenter study to assess anthropometric indices of obesity and to obtain a comprehensive fasting metabolic risk profile. Either risperidone or olanzapine had to be prescribed as the first and only antipsychotic for a minimum of 6 months. Patients were compared with a reference group of nondiabetic men. Data were collected from August 1999 to August 2001.


RESULTS
Eighty-seven patients treated with olanzapine (N = 42) or risperidone (N = 45) were evaluated. Olanzapine-treated patients had significantly higher plasma triglyceride concentrations (2.01 +/-1.05 vs. 1.34 +/-0.65 mmol/L, p < or =.05), lower high-density lipoprotein (HDL)-cholesterol levels (0.92 +/-0.17 vs. 1.04 +/- 0.21 mmol/L, p < or =.05), higher cholesterol/HDL-cholesterol ratios (5.62 +/-1.70 vs. 4.50 +/- 1.44, p < or =.05), higher apolipoprotein B levels (1.07 +/- 0.35 vs. 0.92 +/- 0.27 g/L, p < or =.05), smaller low-density lipoprotein peak particle diameters (252.6 +/-4.1 vs. 255.2 +/-4.3 A, p <.01), and higher fasting insulin concentrations (103.9 +/- 67.6 vs. 87.5 +/- 56.1 pmol/L, p < or =.05) than risperidone-treated patients. Moreover, 33% of olanzapine-treated patients were carriers of 3 atherogenic features of the metabolic syndrome as opposed to a prevalence of only 11% of risperidone-treated patients.


CONCLUSIONS
These results suggest that olanzapine-treated patients are characterized by a more deteriorated metabolic risk factor profile compared with risperidone-treated patients. These observations raise concerns about the potential differential long-term deleterious effects of some antipsychotics, such as olanzapine, on cardiovascular health.
Alméras
Natalie
N
Laval Hospital Research Center, Department of Food Sciences and Nutrition, Laval University, Pavilion Marguerite-D'Youville, 4th floor, 2725 chemin Ste-Foy, Ste-Foy, Québec, Canada G1V 4G5. Natalie.Almeras@crhl.ulaval.ca
Després
Jean-Pierre
JP
Villeneuve
Julie
J
Demers
Marie-France
MF
Roy
Marc-André
MA
Cadrin
Camille
C
Mottard
Jean-Pierre
JP
Bouchard
Roch-Hugo
RH
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood*; D002353:Carrier State; D008076:Cholesterol, HDL / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000139:chemically induced / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005215:Fasting / Q000097:blood / Q000378:metabolism; D006306:Health Surveys; D006801:Humans; D015228:Hypertriglyceridemia / Q000235:genetics / Q000378:metabolism; D007328:Insulin / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000139:chemically induced / Q000378:metabolism*; D009765:Obesity / Q000097:blood / Q000139:chemically induced / Q000378:metabolism; D000077152:Olanzapine; D015995:Prevalence; D011618:Psychotic Disorders / Q000097:blood / Q000188:drug therapy / Q000378:metabolism; D012307:Risk Factors; D018967:Risperidone / Q000009:adverse effects / Q000627:therapeutic use; D015430:Weight Gain / Q000187:drug effects
D014150:Antipsychotic Agents; D015415:Biomarkers; D008076:Cholesterol, HDL; D007328:Insulin; D001569:Benzodiazepines; D018967:Risperidone; D000077152:Olanzapine