Differential effects of olanzapine and clozapine on plasma levels of adipocytokines and total ghrelin

• Published in: Progress in neuro-psychopharmacology & biological psychiatry 2015-04, Vol.58, p.47-50
• Main Authors: Lu, Mong-Liang, Wang, Tsu-Nai, Lin, Tsang-Yaw, Shao, Wen-Chuan, Chang, Sheng-Huang, Chou, Jen-Yu, Ho, Yi-Feng, Liao, Yin-To, Chen, Vincent Chin-Hung
• Format: Article
• Language: English
• Subjects: Adipokines - blood; Adiponectin; Adult; Aging - blood; Aging - drug effects; Antipsychotic Agents - therapeutic use; Benzodiazepines - therapeutic use; Blood Glucose - drug effects; Blood Glucose - metabolism; Body Mass Index; Cholesterol - blood; Clozapine; Clozapine - therapeutic use; Fasting - blood; Female; Ghrelin; Ghrelin - blood; Humans; Leptin; Male; Middle Aged; Olanzapine; Schizophrenia; Schizophrenia - blood; Schizophrenia - drug therapy; Triglycerides - blood
• ISSN: 0278-5846; 1878-4216
• DOI: 10.1016/j.pnpbp.2014.12.001

Second-generation antipsychotics (SGAs) have been associated with an increased liability for weight gain and metabolic side effects. Among SGAs, clozapine and olanzapine had great liability to induce weight gain and metabolic adverse reactions. Leptin, adiponectin, and total ghrelin play important roles in energy homeostasis and are suggested to be biomarkers of metabolic disturbances. The purpose of the present study was to investigate the differential effects of antipsychotics (olanzapine and clozapine) on the levels of adipocytokines (leptin and adiponectin) and total ghrelin. Three hundred and thirty-three patients with schizophrenia under clozapine or olanzapine monotherapy were recruited. Control participants were recruited from a healthy community population based on a health investigation (N=119). Fasting blood samples for glucose, cholesterol, triglycerides, leptin, adiponectin, and total ghrelin were analyzed. There were significant differences in the levels of cholesterol, triglycerides, and glucose between these three groups. Post hoc comparisons showed that the olanzapine group had the highest levels of cholesterol and triglycerides. The levels of leptin, adiponectin, and total ghrelin were also significantly different between the three groups after controlling age and body mass index (BMI). Post hoc comparisons showed that the olanzapine group had the lowest levels of adiponectin and total ghrelin. The present study found that the uses of olanzapine and clozapine were associated with changes in adipocytokines and total ghrelin, even after adjusting potential confounding factors. Olanzapine had greater influences on adiponectin and total ghrelin than clozapine. The changes in adipocytokines and total ghrelin were a direct effect of antipsychotics on hormonal pathways of energy homeostasis, rather than the result of weight gain. •Olanzapine and clozapine were associated with changes in levels of adipocytokines and total ghrelin.•Olanzapine had greater influences on adiponectin and ghrelin levels than clozapine.•The changes in adipocytokines and ghrelin were a direct effect of antipsychotics on hormonal pathways of energy homeostasis.