Metabolic changes in the acute phase with olanzapine treatment

Introduction: Atypical antipsychotics are used in treatment of psychotic disorders and severe behavior disorders. Despite the lack of extra pyramidal side effects, they cause metabolic disorders (such as hyperlipidemia, weight gain, glucose intolerance), which are important causes of mortality (1). The exact mechanisms of these side-effects of atypical antipsychotics have not been identified so far and therefore and protective measures could not be established (2). In this study we aimed to examine the acute phase changes in blood lipid profile and body mass index while using olanzapine.

Materials and Methods: Twenty four patients, who were diagnosed with first-episode psychotic disorder and received olanzapine treatment in the Department of Psychiatry, Gulhane Military Medical Faculty, were enrolled in the study. The serum lipid levels and fasting blood sugars were measured before the treatment and four weeks after the treatment; body mass index was calculated and the data obtained were compared.

Results: The comparison of pre- and post-treatment data showed significant increases in the weight gain, measurement of waist circumference, body mass index, total cholesterol, and VLDL levels (p <0.05). There were statistically no significant changes in fasting blood glucose, HDL, LDL, and TG levels.

Discussion: It is reported that the reason of differences in severity of metabolic changes occurring due to the use of atypical antipsychotics is variation of the genes that encode metabolizing enzymes, transporters, and receptors (3,4). In this study, the changes occurred within four weeks may be predictors of developing long-term metabolic disorders and so that protective measures can be initiated. Identifying the individual differences will contribute to the treatment regimens when weight gain can be detected early in the treatment.

References:
1. Jin H., Meyer J.M., Mudaliar S., Jeste D.V., 2008. Impact of atypical antipsychotic therapy on leptin, ghrelin, and adiponectin. Schizophrenia Research 100 (2008) 70–85.
2. Yazycy K. Yazycy A., 2008. Weight Increase Induced by Antipsychotic drugs:What is the role of genes? Bulletin of Clinical Psychopharmacology 2008;18:59-70.
3. Chagnon YC. Susceptibility genes for the side effect of antipsychotics on body weight and obesity.Curr Drug Targets 2006; 12: 1681-1695
4. Evans WE, Johnson JA. Pharmacogenomics: the inherited basis for interindividual differences in drug response. Annu Rev Genomics Hum Genet 2001; 2: 9-39 Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S171-2