title: Blood lactate levels in patients receiving first- or second- generation antipsychotics.
abstract: OBJECTIVE
  To compare the blood lactate levels between patients with psychotic disorder receiving first- and those receiving second-generation antipsychotics.
  
  
  METHODS
  The study was conducted at the psychiatric inpatient and outpatient clinics of the Split Clinical Hospital from June 6, 2008 to October 10, 2009. Sixty patients with psychotic disorder who were assigned to 6-month treatment were divided in two groups: 30 received haloperidol (first generation antipsychotic) and 30 received olanzapine (second generation antipsychotic). Blood lactate levels, other metabolic parameters, and scores on the extrapyramidal symptom rating scale were assessed.
  
  
  RESULTS
  Patients receiving haloperidol had significantly higher blood lactate levels than patients receiving olanzapine (P < 0.001). They also more frequently had parkinsonism, which was significantly correlated with both haloperidol treatment at 1 month (P < 0.001) and 6 months (P = 0.016) and olanzapine treatment at baseline (P = 0.016), 3 months (P = 0.019), and 6 months (P = 0.021). Also, patients receiving haloperidol had significant correlation between blood lactate and dystonia at 1 month (P < 0.001) and 6 months (P = 0.012) and tardive dyskinesia at 1 month (P = 0.032). There was a significant difference between the treatment groups in lactate levels at all points from baseline to month 6 (P < 0.001).
  
  
  CONCLUSIONS
  It is important to be aware of the potential effect of haloperidol treatment on increase in blood lactate levels and occurrence of extrapyramidal side effects. Therefore, alternative antipsychotics should be prescribed with lower risk of adverse side effects.
authors.affiliation: Psychiatric Clinic, Split ClinicalHospital Center, Split, Croatia. trpimir.glavina@st.htnet.hr
authors.forename: Trpimir
authors.initials: T
authors.lastname: Glavina
authors.forename: Damir
authors.initials: D
authors.lastname: Mrass
authors.forename: Tajana
authors.initials: T
authors.lastname: Dodig
authors.forename: Gordana
authors.initials: G
authors.lastname: Glavina
authors.forename: Shelly
authors.initials: S
authors.lastname: Pranić
authors.forename: Boran
authors.initials: B
authors.lastname: Uglešić
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000819:agonists; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects; D018492:Dopamine Antagonists / Q000008:administration & dosage / Q000009:adverse effects; D016903:Drug Monitoring; D006220:Haloperidol / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D019344:Lactic Acid / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism*; D000077152:Olanzapine; D010302:Parkinson Disease, Secondary / Q000139:chemically induced / Q000175:diagnosis / Q000378:metabolism*; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D018492:Dopamine Antagonists; D006220:Haloperidol; D019344:Lactic Acid; D000077152:Olanzapine; D017367:Selective Serotonin Reuptake Inhibitors