Naturalistic observation on the hepatic enzyme changes in patients treated with either risperidone or olanzapine alone.
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.
Pae
Chi-Un
CU
Department of Psychiatry, The Catholic University of Korea College of Medicine, Seocho-Gu, Seoul, Korea.
Lim
Hyun-Kook
HK
Kim
Tae-Suk
TS
Kim
Jung-Jin
JJ
Lee
Chang-Uk
CU
Lee
Soo-Jung
SJ
Lee
Chul
C
Paik
In-Ho
IH
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000378:metabolism; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001219:Aspartate Aminotransferases / Q000097:blood; D001569:Benzodiazepines / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007297:Inpatients; D008099:Liver / Q000187:drug effects / Q000201:enzymology*; D008111:Liver Function Tests; D008297:Male; D000077152:Olanzapine; D011618:Psychotic Disorders / Q000188:drug therapy / Q000201:enzymology; D012189:Retrospective Studies; D018967:Risperidone / Q000009:adverse effects* / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy / Q000201:enzymology
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D018967:Risperidone; D000077152:Olanzapine