title: Effects of switching from olanzapine to aripiprazole on the metabolic profiles of patients with schizophrenia and metabolic syndrome: a double-blind, randomized, open-label study.
abstract: BACKGROUND
  Patients with schizophrenia suffer high rates of metabolic derangements on some antipsychotic medications that predispose them to cardiovascular diseases. Keeping this fact in mind, we planned this open-label study to see the effect on various metabolic parameters after switching stable schizophrenia subjects, who had developed metabolic syndrome on olanzapine, to aripiprazole.
  
  
  METHODS
  Sixty-two patients with schizophrenia who were stable on olanzapine and were fulfilling modified National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP-III) criteria for the presence of metabolic syndrome were enrolled on the study. Patients were randomly assigned either to switch to aripiprazole or to stay on olanzapine, on a 1:1 basis. Cross-tapering over a period of 1 month was done while switching patients to aripiprazole. Laboratory assessment for metabolic parameters was done at baseline, 8 weeks, and 24 weeks after enrollment; efficacy assessment was done using the Positive and Negative Syndrome Scale (PANSS) at baseline and 24 weeks, the Clinical Global Impressions severity subscale (CGI-S) at baseline, and the Clinical Global Impressions improvement subscale (CGI-I) at 24 weeks.
  
  
  RESULTS
  All parameters of metabolic syndrome (waist circumference, blood pressure, triglyceride level, fasting blood glucose, and high-density lipoprotein cholesterol) kept deteriorating in the stay group, compared with a continuous improvement in the switch group over time. At the end of the study, 26 patients (100%) from the stay group and 15 patients (42.8%) from switch group met the modified NCEP ATP-III criteria for presence of metabolic syndrome (P<0.001). There were no statistically significant differences between groups in psychopathology changes as measured by the PANSS total score and CGI-I scores.
  
  
  CONCLUSIONS
  Clinically stable patients with schizophrenia who are taking olanzapine and who have evidence of metabolic syndrome can be successfully switched to aripiprazole, with improvement in various parameters of metabolic syndrome and without any significant change in efficacy measures.
authors: Department of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir, India.
authors: Rayees Ahmad
authors: RA
authors: Wani
authors: Department of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir, India.
authors: Mansoor Ahmad
authors: MA
authors: Dar
authors: Department of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir, India.
authors: Rajesh Kumar
authors: RK
authors: Chandel
authors: Department of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir, India.
authors: Yasir Hassan
authors: YH
authors: Rather
authors: Department of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir, India.
authors: Inaamul
authors: I
authors: Haq
authors: Department of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir, India.
authors: Arshad
authors: A
authors: Hussain
authors: Department of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir, India.
authors: Altaf Ahmad
authors: AA
authors: Malla
keywords: aripiprazole; metabolic syndrome; olanzapine; schizophrenia; switching