Changes in metabolic parameters with switching to aripiprazole from another second-generation antipsychotic: a retrospective chart review.
OBJECTIVE
This is a retrospective chart review of psychiatric outpatients switched to aripiprazole from another second-generation antipsychotic (SGA) examining whether metabolic parameters improved after the switch.


METHODS
Twenty-four psychiatric outpatients who had been switched to aripiprazole from another SGA were evaluated. Data were collected from October 6, 2004, until February 25, 2005, through review of medical records. Laboratory values and physical data were extracted to assess levels of fasting blood glucose, triglycerides, total cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL), and weight.


RESULTS
After switching to aripiprazole, total cholesterol was significantly decreased, with a mean (SD) difference of -28.8 (32.1) mg/dL (p = .001), and LDL was significantly decreased, with a mean (SD) difference of -20.75 (21.7) mg/dL (p = .0017). Weight was also significantly decreased, with a mean (SD) difference of -11.7 (16.6) lb (p = .003). There were no significant differences in HDL, triglycerides, or fasting blood glucose. When a subgroup of 15 patients switched from olanzapine to aripiprazole was examined separately, these changes were even more robust. In this subgroup, total cholesterol was significantly decreased, with a mean (SD) difference of -32.0 (35.6) mg/dL (p = .01). LDL was significantly decreased, with a mean (SD) difference of -21.6 (24.7) mg/dL (p = .011), and weight was significantly decreased, with a mean (SD) difference of -16.7 (14.7) lb (p < .001). Changes in total cholesterol, LDL, and HDL were not significantly different between subjects taking lipid-lowering medications and those not taking them.


CONCLUSIONS
Psychiatric outpatients switched to aripiprazole from another SGA showed a decrease in weight, total cholesterol, and LDL. Switching to aripiprazole, when clinically indicated, may lead to improvement in metabolic parameters associated with cardiovascular disease.
Spurling
Ronald D
RD
Department of Psychiatry, University of Rochester, Strong Memorial Hospital, Rochester, NY 14642, USA. ronald_spurling@urmc.rochester.edu
Lamberti
J Steven
JS
Olsen
David
D
Tu
Xin
X
Tang
Wan
W
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000068180:Aripiprazole; D008076:Cholesterol, HDL / Q000097:blood* / Q000187:drug effects; D008078:Cholesterol, LDL / Q000097:blood* / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010879:Piperazines / Q000009:adverse effects* / Q000627:therapeutic use; D015363:Quinolones / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy; D015431:Weight Loss
D014150:Antipsychotic Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D010879:Piperazines; D015363:Quinolones; D000068180:Aripiprazole