title: Metabolic syndrome and drug discontinuation in schizophrenia: a randomized trial comparing aripiprazole olanzapine and haloperidol.
abstract: OBJECTIVE
  To determine whether the prescription of aripiprazole, compared with olanzapine and haloperidol, was associated with a lower frequency of metabolic syndrome (MS) and treatment discontinuation at 1 year.
  
  
  METHODS
  Patients were randomly assigned to be treated open-label and according to usual clinical practice with either aripiprazole, olanzapine, or haloperidol and followed up for 1 year.
  
  
  RESULTS
  Three hundred out-patients with persistent schizophrenia were recruited in 35 mental health services. The intention-to-treat (ITT) analysis found no significant differences in the rate of MS between aripiprazole (37%), olanzapine (47%), and haloperidol (42%). Treatment discontinuation for any cause was higher for aripiprazole (52%) than for olanzapine (33%; OR, 0.41; P = 0.004), or haloperidol (37%; OR, 0.51; P = 0.030). No significant difference was found between olanzapine and haloperidol. Time to discontinuation for any cause was longer for olanzapine than for aripiprazole (HR, 0.55; P < 0.001). No significant differences were found between haloperidol and aripiprazole, or between olanzapine and haloperidol.
  
  
  CONCLUSIONS
  The prescription of aripiprazole did not significantly reduce the rates of MS, but its treatment retention was worse. Aripiprazole cannot be considered the safest and most effective drug for maintenance treatment of schizophrenia in routine care, although it may have a place in antipsychotic therapy.
authors.affiliation: IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Parabiaghi
authors.affiliation: IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Tettamanti
authors.affiliation: IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy.
authors.forename: B
authors.initials: B
authors.lastname: D'Avanzo
authors.affiliation: IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Barbato
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000068180:Aripiprazole / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006220:Haloperidol / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000139:chemically induced*; D008875:Middle Aged; D000077152:Olanzapine; D012559:Schizophrenia / Q000188:drug therapy* / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000068180:Aripiprazole; D006220:Haloperidol; D000077152:Olanzapine
keywords: adverse effects; antipsychotic drugs; clinical trial; effectiveness