title: Relationships between pharmacotherapy-induced metabolic changes and improved psychopathology in schizophrenia: data from a mirtazapine and first-generation antipsychotics combination trial.
abstract: Clinical efficacy and metabolic side-effects of antipsychotics seem to correlate with each other. In this study, interrelationship of similar metabolic effects of mirtazapine and its earlier reported desirable effects on psychopathology in first-generation antipsychotics (FGAs)-treated schizophrenia were explored. Symptomatic FGAs-treated patients with schizophrenia received a 6-wk double-blind treatment with add-on mirtazapine (n = 20) or placebo (n = 16), followed by a 6-wk open-label mirtazapine treatment. Mirtazapine (but not placebo) induced an increase in body weight and cholesterol levels. The latter was associated with a clinical improvement in all (sub)scales of the Positive and Negative Syndrome Scale [PANSS; an increase of cholesterol by 1 mmol/l predicted 7 points reduction on the PANSS total score (r = 0.85, p = 0.001)]. In schizophrenia, mirtazapine-induced weight gain and increase of total cholesterol are associated with the improved efficacy of mirtazapine-FGAs combination--a novel observation with possible clinical and theoretical implications.
authors.affiliation: Kellokoski Hospital, Kellokoski, Finland. viacheslav.terevnikov@hus.fi
authors.forename: Viacheslav
authors.initials: V
authors.lastname: Terevnikov
authors.forename: Jan-Henry
authors.initials: JH
authors.lastname: Stenberg
authors.forename: Jari
authors.initials: J
authors.lastname: Tiihonen
authors.forename: Evgeni
authors.initials: E
authors.lastname: Chukhin
authors.forename: Marina
authors.initials: M
authors.lastname: Joffe
authors.forename: Mark
authors.initials: M
authors.lastname: Burkin
authors.forename: Grigori
authors.initials: G
authors.lastname: Joffe
mesh_terms: D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008659:Metabolic Diseases / Q000139:chemically induced*; D008803:Mianserin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000078785:Mirtazapine; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000188:drug therapy*; D013223:Statistics as Topic; D013997:Time Factors; D055815:Young Adult
chemical_list: D000929:Antidepressive Agents, Tricyclic; D014150:Antipsychotic Agents; D008803:Mianserin; D000078785:Mirtazapine