Comparison of metabolic effects of aripiprazole, quetiapine and ziprasidone after 12 weeks of treatment in first treated episode of psychosis

• Published in: Schizophrenia research 2014-10, Vol.159 (1), p.90-94
• Main Authors: Pérez-Iglesias, Rocio, Ortiz-Garcia de la Foz, Victor, Martínez García, Obdulia, Amado, Jose Antonio, Garcia-Unzueta, M. Teresa, Ayesa-Arriola, Rosa, Suarez-Pinilla, Paula, Tabares-Seisdedos, Rafael, Crespo-Facorro, Benedicto
• Format: Article
• Language: English
• Subjects: Adult; Antipsychotic Agents - adverse effects; Antipsychotic Agents - therapeutic use; Aripiprazole; Biological and medical sciences; Cholesterol - blood; Dibenzothiazepines - adverse effects; Dibenzothiazepines - therapeutic use; Female; Follow-Up Studies; Humans; Male; Medical sciences; Neuropharmacology; Pharmacology. Drug treatments; Piperazines - adverse effects; Piperazines - therapeutic use; Prolactin - metabolism; Psychiatry; Psycholeptics: tranquillizer, neuroleptic; Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; Psychotic Disorders - drug therapy; Quetiapine Fumarate; Quinolones - adverse effects; Quinolones - therapeutic use; Sex Factors; Thiazoles - adverse effects; Thiazoles - therapeutic use; Weight Gain - drug effects
• ISSN: 0920-9964; 1573-2509
• DOI: 10.1016/j.schres.2014.07.045

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.