Risk of lipid abnormality with haloperidol, olanzapine, quetiapine, and risperidone in a Veterans Affairs population.
Second-generation antipsychotics can cause lipid elevations at a greater rate than older typical antipsychotics. This risk may not be equivalent amongst the second-generation antipsychotics. We conducted a computerized, retrospective, nonrandomized, case-control analysis of 6331 patients receiving antipsychotics. For each patient, the first prescription for at least 60 continuous days for four antipsychotics [haloperidol (HALD), olanzapine (OLANZ), quetiapine (QUET), or risperidone (RISP)] was analyzed for total cholesterol, low-density lipoprotein, high-density lipoprotein (HDL), and triglycerides (TGL). Mean HDL was lower during OLANZ treatment than with RISP (P = 0.03) or QUET (P = 0.001). TGL were higher during OLANZ (P = 0.0007) or QUET treatment (P = 0.006) than RISP. In dichotomous analyses, odds ratios on the percentage of participants having abnormal cholesterol (P = 0.0003), low-density lipoprotein (P = 0.001), or TGL (P = 0.0001) during medication were in the order: OLANZ > QUET > RISP > HALD. For HDL, the results were less robust but the percentage of participants were in the order: OLANZ>RISP = HALD = QUET. In treatment-emergent analyses of patients without lipid abnormalities during an unmedicated baseline period, there was a greater risk of developing new HDL abnormality with OLANZ than RISP (P<0.05). In conclusion, treatment with RISP or HALD was associated with a more favorable lipid profile than with OLANZ or QUET.
Duncan
Erica J
EJ
Mental Health Service, Atlanta VA Medical Center, GA 30033, USA. erica.duncan@va.gov
Woolson
Sandra L
SL
Hamer
Robert M
RM
Dunlop
Boadie W
BW
D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001569:Benzodiazepines / Q000009:adverse effects*; D016022:Case-Control Studies; D003987:Dibenzothiazepines / Q000009:adverse effects*; D050171:Dyslipidemias / Q000139:chemically induced*; D005260:Female; D006220:Haloperidol / Q000009:adverse effects*; D006801:Humans; D015228:Hypertriglyceridemia / Q000139:chemically induced*; D008297:Male; D000077152:Olanzapine; D000069348:Quetiapine Fumarate; D012189:Retrospective Studies; D018570:Risk Assessment / Q000706:statistics & numerical data; D018967:Risperidone / Q000009:adverse effects*; D013997:Time Factors; D014481:United States; D014493:United States Department of Veterans Affairs
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D006220:Haloperidol; D018967:Risperidone; D000077152:Olanzapine