title: Metabolic impact of switching antipsychotic therapy to aripiprazole after weight gain: a pilot study.
abstract: Switching antipsychotic regimen to agents with low weight gain potential has been suggested in patients who gain excessive weight on their antipsychotic therapy. In an open-label pilot study, we evaluated the metabolic and psychiatric efficacy of switching to aripiprazole in 15 (9 men, 6 women) outpatients with schizophrenia who had gained at least 10 kg on their previous antipsychotic regimen. Individuals had evaluation of glucose tolerance, insulin resistance (insulin suppression test), lipid concentrations, and psychiatric status before and after switching to aripiprazole for 4 months. A third of the individuals could not psychiatrically tolerate switching to aripiprazole. In the remaining individuals, psychiatric symptoms significantly improved with decline in Clinical Global Impression Scale (by 26%, P = 0.015) and Positive and Negative Syndrome Scale (by 22%, P = 0.023). Switching to aripiprazole did not alter weight or metabolic outcomes (fasting glucose, insulin resistance, and lipid concentrations) in the patients of whom 73% were insulin resistant and 47% had impaired or diabetic glucose tolerance at baseline. In conclusion, switching to aripiprazole alone does not ameliorate the highly prevalent metabolic abnormalities in the schizophrenia population who have gained weight on other second generation antipsychotic medications.
authors.affiliation: Division of Endocrinology, Stanford University, Stanford, CA, USA. sunhkim@stanford.edu
authors.forename: Sun H
authors.initials: SH
authors.lastname: Kim
authors.forename: Oxana
authors.initials: O
authors.lastname: Ivanova
authors.forename: Fahim A
authors.initials: FA
authors.lastname: Abbasi
authors.forename: Cindy A
authors.initials: CA
authors.lastname: Lamendola
authors.forename: Gerald M
authors.initials: GM
authors.lastname: Reaven
authors.forename: Ira D
authors.initials: ID
authors.lastname: Glick
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000068180:Aripiprazole; D002318:Cardiovascular Diseases / Q000150:complications / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008074:Lipoproteins / Q000097:blood; D008297:Male; D008660:Metabolism / Q000187:drug effects*; D008875:Middle Aged; D010865:Pilot Projects; D010879:Piperazines / Q000009:adverse effects* / Q000627:therapeutic use; D011788:Quality of Life; D015363:Quinolones / Q000009:adverse effects* / Q000627:therapeutic use; D012307:Risk Factors; D012559:Schizophrenia / Q000150:complications* / Q000188:drug therapy; D012565:Schizophrenic Psychology; D015430:Weight Gain / Q000187:drug effects*
chemical_list: D014150:Antipsychotic Agents; D008055:Lipids; D008074:Lipoproteins; D010879:Piperazines; D015363:Quinolones; D000068180:Aripiprazole