Glucose and lipid metabolism of long-term risperidone monotherapy in patients with schizophrenia.
Risperidone has a relatively low risk of causing obesity and diabetes mellitus and is a first-line treatment for schizophrenia. The aim of the present study was to investigate glucose and lipid metabolism, and feeding-control parameters in schizophrenia patients treated with long-term risperidone monotherapy. Fifteen patients with paranoid-type schizophrenia who had been treated with risperidone and had Global Assessment of Function (GAF) scores >70 were selected and compared with healthy volunteers (n = 25). Single assessments of psychotic symptoms, side-effects, Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS) score, bodyweight, body fat percentage and blood sampling were performed. Fasting blood glucose, insulin, hemoglobin A1c, homeostasis model assessment insulin resistance index (HOMA-IR), total cholesterol, triglyceride, high density lipoprotein (HDL)-, low density lipoprotein-cholesterol, adiponectin, prolactin and feeding-control parameters (ghrelin and leptin) were analyzed. The body fat percentage (P = 0.0018), body mass index (BMI) (P = 0.0150), fasting blood glucose (P = 0.0358), triglyceride (P = 0.0377), leptin (P = 0.0243), total ghrelin (P = 0.0067), active ghrelin (P = 0.0241) and prolactin (P < 0.0001) levels of patients treated with risperidone were significantly higher than those of healthy volunteers, while the HDL-cholesterol level (P = 0.0222) was significantly lower. Although the patients had very mild psychiatric symptoms and maintained functionally high levels, the glucose and lipid parameters were significantly impaired compared to healthy volunteers. A high level of plasma ghrelin might increase appetite, leading to exacerbation of metabolic impairment.
Murashita
Mari
M
Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan. tm-mura@jb3.so-net.ne.jp
Inoue
Takeshi
T
Kusumi
Ichiro
I
Nakagawa
Shin
S
Itoh
Kouichi
K
Tanaka
Teruaki
T
Izumi
Takeshi
T
Hosoda
Hiroshi
H
Kangawa
Kenji
K
Koyama
Tsukasa
T
D052242:Adiponectin / Q000097:blood; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001823:Body Composition / Q000187:drug effects; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D054439:Ghrelin; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000378:metabolism; D020738:Leptin / Q000097:blood / Q000378:metabolism; D050356:Lipid Metabolism / Q000187:drug effects*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D036361:Peptide Hormones / Q000097:blood / Q000378:metabolism; D011569:Psychiatric Status Rating Scales; D018967:Risperidone / Q000009:adverse effects* / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy / Q000378:metabolism*; D015430:Weight Gain / Q000187:drug effects
D052242:Adiponectin; D014150:Antipsychotic Agents; D008076:Cholesterol, HDL; D054439:Ghrelin; D020738:Leptin; D008055:Lipids; D036361:Peptide Hormones; D005947:Glucose; D018967:Risperidone