title: Comparison of metabolic effects of aripiprazole, quetiapine and ziprasidone after 12 weeks of treatment in first treated episode of psychosis.
abstract: This randomized open-label study compared the incidence of metabolic side effects of aripiprazole, ziprasidone and quetiapine in a population of medication-naïve first-episode psychosis patients. A total of 202 subjects were enrolled. Body weight, body mass index, leptin, fasting lipids and fasting glycaemic parameters were measured at baseline and at 3 months follow-up. A hundred and sixty-six patients completed the follow-up and were included in the analyses. A high proportion of patients experienced a significant weight increase (>7% of their baseline weight): 23% ziprasidone (n=12), 32% with quetiapine (n=16) and 45% with aripiprazole (n=31). Patients treated with aripiprazole gained significantly more weight than the patients in the ziprasidone group (1.2 kg [SD=4.1] versus 4.3 kg [SD=4.8], respectively). The increase in leptin levels was greater in women treated with aripiprazole than in those treated with ziprasidone (p=0.030). Mean prolactin levels significantly increased in patients treated with quetiapine and ziprasidone but not in those treated with aripiprazole. Patients treated with quetiapine and aripiprazole showed a significant increase in total cholesterol and LDL-cholesterol plasma levels. Quetiapine-treated patients resulted in a higher increase in LDL-cholesterol than patients treated with ziprasidone (p=0.021). No other significant differences between groups were found. No significant changes in glycaemic parameters were observed. Our results suggest that ziprasidone has a lower liability for inducing weight gain and lipid abnormalities than aripiprazole or quetiapine.
authors.affiliation: Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK; CIBERSAM: Centro de Investigación Biomédica en Red en el área de Salud Mental Spain. Electronic address: rocio.perez-iglesias@kcl.ac.uk.
authors.forename: Rocio
authors.initials: R
authors.lastname: Pérez-Iglesias
authors.affiliation: CIBERSAM: Centro de Investigación Biomédica en Red en el área de Salud Mental Spain; Department of Psychiatry, Marques de Valdecilla University Hospital, Santander 39008, Spain.
authors.forename: Victor
authors.initials: V
authors.lastname: Ortiz-Garcia de la Foz
authors.affiliation: CIBERSAM: Centro de Investigación Biomédica en Red en el área de Salud Mental Spain; Department of Psychiatry, Marques de Valdecilla University Hospital, Santander 39008, Spain.
authors.forename: Obdulia
authors.initials: O
authors.lastname: Martínez García
authors.affiliation: Department of Endocrinology, Marques de Valdecilla University Hospital, Santander 39008, Spain.
authors.forename: Jose Antonio
authors.initials: JA
authors.lastname: Amado
authors.affiliation: Department of Biochemistry, Marques de Valdecilla University Hospital, Santander 39008, Spain.
authors.forename: M Teresa
authors.initials: MT
authors.lastname: Garcia-Unzueta
authors.affiliation: CIBERSAM: Centro de Investigación Biomédica en Red en el área de Salud Mental Spain; Department of Psychiatry, Marques de Valdecilla University Hospital, Santander 39008, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Ayesa-Arriola
authors.affiliation: Department of Psychiatry, Marques de Valdecilla University Hospital, Santander 39008, Spain.
authors.forename: Paula
authors.initials: P
authors.lastname: Suarez-Pinilla
authors.affiliation: CIBERSAM: Centro de Investigación Biomédica en Red en el área de Salud Mental Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Tabares-Seisdedos
authors.affiliation: CIBERSAM: Centro de Investigación Biomédica en Red en el área de Salud Mental Spain; Department of Psychiatry, Marques de Valdecilla University Hospital, Santander 39008, Spain.
authors.forename: Benedicto
authors.initials: B
authors.lastname: Crespo-Facorro
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000068180:Aripiprazole; D002784:Cholesterol / Q000097:blood; D003987:Dibenzothiazepines / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use*; D011388:Prolactin / Q000378:metabolism; D011618:Psychotic Disorders / Q000188:drug therapy*; D000069348:Quetiapine Fumarate; D015363:Quinolones / Q000009:adverse effects / Q000627:therapeutic use*; D012737:Sex Factors; D013844:Thiazoles / Q000009:adverse effects / Q000627:therapeutic use*; D015430:Weight Gain / Q000187:drug effects
chemical_list: D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D010879:Piperazines; D015363:Quinolones; D013844:Thiazoles; D000069348:Quetiapine Fumarate; C092292:ziprasidone; D000068180:Aripiprazole; D011388:Prolactin; D002784:Cholesterol
keywords: Aripiprazole; First-episode psychosis; Leptin; Medication-naïve; Metabolic side effects; Prolactin; Quetiapine; Weight gain; Ziprasidone