Sex difference in effects of typical and atypical antipsychotics on glucose-insulin homeostasis and lipid metabolism in first-episode schizophrenia.
OBJECTIVE
The present study was to investigate the sex difference in effects of clozapine, olanzapine, risperidone, and sulpiride on glucose and lipid metabolism in first-episode schizophrenia.


METHODS
One hundred twelve patients with schizophrenia were assigned randomly to receive clozapine, olanzapine, risperidone, or sulpiride for 8 weeks. Planned assessments included body mass index, waist-hip ratio, fasting glucose, insulin, C-peptide, insulin resistance index (IRI), cholesterol and triglyceride levels. All measures were collected at baseline and at the end of the 8-week treatment.


RESULTS
After treatment, waist-hip ratio and triglyceride and IRI levels of men were increased higher than that of women in clozapine and olanzapine groups. In sulpiride group, body mass index and triglyceride, insulin, and IRI levels of women increased higher than those of men. There was no significant sex difference for all assessments in risperidone group. Insulin, C-peptide, and IRI, but not fasting glucose levels, were significantly increased in the 4 groups. Cholesterol and triglyceride levels were significantly increased in the clozapine and olanzapine groups. Patients treated with clozapine and olanzapine had higher fasting insulin, C-peptide, and IRI levels than those treated with risperidone and sulpiride.


CONCLUSIONS
These results suggest that clozapine, olanzapine, and sulpiride had effects on glucose and lipid metabolism in first-episode schizophrenia with sex difference. Clozapine and olanzapine seem to have the greatest potential to induce glucose and lipid metabolism abnormalities, and risperidone has the least.
Wu
Ren-Rong
RR
Institute of Mental Health, Second Xiangya Hospital, Central South University, Hunan, China.
Zhao
Jing-Ping
JP
Zhai
Jin-Guo
JG
Guo
Xiao-Feng
XF
Guo
Wen-Bin
WB
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects; D002096:C-Peptide / Q000097:blood; D002784:Cholesterol / Q000097:blood; D005260:Female; D006706:Homeostasis / Q000187:drug effects*; D006801:Humans; D007328:Insulin / Q000097:blood*; D050356:Lipid Metabolism / Q000187:drug effects*; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012559:Schizophrenia / Q000188:drug therapy / Q000378:metabolism*; D012727:Sex Characteristics; D014280:Triglycerides / Q000097:blood
D014150:Antipsychotic Agents; D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin; D014280:Triglycerides; D002784:Cholesterol