title: Metabolic effects of olanzapine in patients with newly diagnosed psychosis.
abstract: Antipsychotic medications are associated with an increased risk of diabetes. Previous studies have also found an increased risk of type 2 diabetes mellitus in the relatives of schizophrenia probands. The aim of this study was to explore the metabolic adverse effects of olanzapine in a cohort of patients with newly diagnosed psychosis and minimal or no exposure to antipsychotics. Patients with newly diagnosed psychosis (n = 30) were enrolled in a 16-week open trial of olanzapine. Body mass index, fasting glucose, hemoglobin A1c, fasting insulin, IL-6, and a fasting lipid profile were measured at baseline and at 4-week intervals. There was a significant, linear increase over time in fasting glucose (P = 0.043), weight (P < 0.001), body mass index (P < 0.001), total cholesterol (P = 0.005), triglycerides (P = 0.003), and low-density lipoprotein (P = 0.013), but not hemoglobin A1c (P = 0.691), fasting insulin (P = 0.690), IL-6 (P = 0.877), or high-density lipoprotein (P = 0.446). An abnormal baseline IL-6 was a significant predictor of a greater increase in both total cholesterol (P < 0.01) and low-density lipoprotein (P < 0.01). Otherwise, neither parental history of type 2 diabetes mellitus nor baseline IL-6 predicted changes in metabolic measures. Changes in metabolic measures with olanzapine treatment can be detected early in the treatment of patients who are previously antipsychotic naive. The absence of a change in fasting insulin suggests a failure of pancreatic islet cells to compensate for the increase in fasting glucose.
authors.affiliation: Department of Psychiatry, University of Cambridge, Cambridgeshire and Peterborough Mental Health Trust, United Kingdom.
authors.forename: Emilio
authors.initials: E
authors.lastname: Fernandez-Egea
authors.forename: Brian
authors.initials: B
authors.lastname: Miller
authors.forename: Clemente
authors.initials: C
authors.lastname: Garcia-Rizo
authors.forename: Miguel
authors.initials: M
authors.lastname: Bernardo
authors.forename: Brian
authors.initials: B
authors.lastname: Kirkpatrick
mesh_terms: D000293:Adolescent; D000328:Adult; D001569:Benzodiazepines / Q000009:adverse effects / Q000097:blood* / Q000627:therapeutic use*; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D011237:Predictive Value of Tests; D011618:Psychotic Disorders / Q000097:blood* / Q000175:diagnosis* / Q000188:drug therapy; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007328:Insulin; D015850:Interleukin-6; D001569:Benzodiazepines; D000077152:Olanzapine