title: A randomized, 12-week study of the effects of extended-release paliperidone (paliperidone ER) and olanzapine on metabolic profile, weight, insulin resistance, and β-cell function in schizophrenic patients.
abstract: OBJECTIVE
  To compare matched paliperidone-ER- and olanzapine-treated schizophrenic patients on measures of glucose and lipid metabolism.
  
  
  METHODS
  Eighty hospitalized patients with schizophrenia (DSM-IV) were randomly assigned to treatment with paliperidone ER or olanzapine for a period of 12 weeks. At baseline and every 4 weeks, we assessed weight, subcutaneous fat, waist and hip circumferences, fasting glucose, insulin, glycohemoglobin A1, cholesterol, triglycerides, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, and prolactin. We also assessed at every time point body mass index (BMI), homeostasis insulin resistance (HOMA-IR), and homeostasis β-cell function (HOMA-B).
  
  
  RESULTS
  Thirty-three patients randomly assigned to paliperidone ER and 23 patients randomly assigned to olanzapine groups completed the entire 12-week treatment. Within-group analyses showed that fasting measures in both groups increased for weight, BMI, waist circumferences, hip circumference, subcutaneous fat, cholesterol, triglycerides, and prolactin. In contrast, fasting glucose, LDL, and HOMA-B increased during treatment only in the olanzapine group. We also detected significantly different serum prolactin levels at all time point between the paliperidone ER- and olanzapine-treated groups, as well as a statistical trend for HOMA-B to increase more in the olanzapine compared to paliperidone-ER group over the 12 weeks of the trial. We did not detect, however, differential drug effects over the 12 weeks of the trial on fasting measures of BMI, glucose, glycohemoglobin A1, insulin, HDL, LDL, cholesterol, triglyceride, or HOMA-IR.
  
  
  CONCLUSIONS
  This study reinforces the necessity of regularly monitoring metabolic parameters in patients with schizophrenia taking atypical antipsychotics, including paliperidone ER.
authors.affiliation: Department of Mental Health, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
authors.forename: Shaohua
authors.initials: S
authors.lastname: Hu
authors.forename: Mingrong
authors.initials: M
authors.lastname: Yao
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Peterson
authors.forename: Dongrong
authors.initials: D
authors.lastname: Xu
authors.forename: Jianbo
authors.initials: J
authors.lastname: Hu
authors.forename: Jianliang
authors.initials: J
authors.lastname: Tang
authors.forename: Bing
authors.initials: B
authors.lastname: Fan
authors.forename: Zhengluan
authors.initials: Z
authors.lastname: Liao
authors.forename: Tianyi
authors.initials: T
authors.lastname: Yuan
authors.forename: Yaling
authors.initials: Y
authors.lastname: Li
authors.forename: Weiqing
authors.initials: W
authors.lastname: Yue
authors.forename: Ning
authors.initials: N
authors.lastname: Wei
authors.forename: Weihua
authors.initials: W
authors.lastname: Zhou
authors.forename: Manli
authors.initials: M
authors.lastname: Huang
authors.forename: Yi
authors.initials: Y
authors.lastname: Xu
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects* / Q000627:therapeutic use; D001786:Blood Glucose / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D003692:Delayed-Action Preparations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000378:metabolism; D007555:Isoxazoles / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D050356:Lipid Metabolism / Q000187:drug effects; D008297:Male; D000077152:Olanzapine; D000068882:Paliperidone Palmitate; D011446:Prospective Studies; D011743:Pyrimidines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy*; D013997:Time Factors; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D001786:Blood Glucose; D003692:Delayed-Action Preparations; D007555:Isoxazoles; D011743:Pyrimidines; D001569:Benzodiazepines; D000077152:Olanzapine; D000068882:Paliperidone Palmitate
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