title: Comparison of metabolic effects of ziprasidone versus olanzapine treatment in patients with first-episode schizophrenia.
abstract: OBJECTIVE
  The objective of the study was to compare metabolic effects of ziprasidone versus olanzapine treatment in patients with first-episode schizophrenia.
  
  
  METHODS
  In this 6-week, multicenter, open-label trial, 260 patients were randomly assigned to receive ziprasidone or olanzapine treatment (130 per group). Primary metabolic measures were changes in weight and body mass index (BMI). Secondary metabolic measures were changes in glucose, insulin, lipids, and blood pressure. Efficacy and safety were also measured additionally.
  
  
  RESULTS
  A total number of 230 patients completed the study. The mean daily dosages were 138.2(28.6) mg for ziprasidone and 19.0(2.3) mg for olanzapine. After 6-week treatment, there were significant between-group differences in change scores on weight [4.22(3.49) kg versus -0.84(2.04) kg, p < 0.001] and BMI [1.59(1.37) versus -0.30(0.74), p < 0.001]. In addition, there were significant between-group differences in change scores on fasting plasma glucose, insulin, homeostasis model assessment 2-insulin resistance, low-density lipoprotein, total cholesterol, and triglycerides (p < 0.001); all the changes were clinically in favor of ziprasidone treatment. Both medications were effective in improving schizophrenia symptoms, but the decreases in Positive and Negative Syndrome Scale total scores of the olanzapine group were significantly greater than that of the ziprasidone group (p < 0.05). Compared with olanzapine, ziprasidone also induced more prolonging of corrected QT interval and extrapyramidal side effects (p < 0.05). Both medications were well tolerated, and no serious adverse events were observed in either group.
  
  
  CONCLUSIONS
  Compared with olanzapine, ziprasidone treatment was associated with less adverse effects on glucose and lipid metabolism in patients with first-episode schizophrenia.
authors.affiliation: Institute of Mental Health of the Second Xiangya Hospital, Central South University, 139 Middle Renmin Road, Changsha, Hunan, People's Republic of China.
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Ou
authors.forename: Yi
authors.initials: Y
authors.lastname: Xu
authors.forename: Hong-Hui
authors.initials: HH
authors.lastname: Chen
authors.forename: Xiaoduo
authors.initials: X
authors.lastname: Fan
authors.forename: Keming
authors.initials: K
authors.lastname: Gao
authors.forename: Juan
authors.initials: J
authors.lastname: Wang
authors.forename: Xiao-Feng
authors.initials: XF
authors.lastname: Guo
authors.forename: Ren-Rong
authors.initials: RR
authors.lastname: Wu
authors.forename: Jing-Ping
authors.initials: JP
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001835:Body Weight / Q000187:drug effects; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000378:metabolism; D050356:Lipid Metabolism / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D010879:Piperazines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy* / Q000378:metabolism*; D013844:Thiazoles / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D007328:Insulin; D010879:Piperazines; D013844:Thiazoles; D001569:Benzodiazepines; C092292:ziprasidone; D005947:Glucose; D000077152:Olanzapine