Weight gain, metabolic parameters, and the impact of race in aggressive inpatients randomized to double-blind clozapine, olanzapine or haloperidol

Menahem Krakowski, P. Czobor, Leslie Citrome

Research output: Contribution to journalArticle

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Abstract

Objective: The second-generation antipsychotic agents clozapine and olanzapine have been associated with weight gain and increased lipid and glucose blood levels. Since some of the neurotransmitters that are impaired in aggressive patients are involved in lipid/glucose metabolism, aggressive patients may represent a subgroup with a differential profile of adverse metabolic reactions to these medications. The goal of this study was to assess the effects of clozapine and olanzapine in comparison to the first-generation agent haloperidol on these metabolic parameters in aggressive patients with schizophrenia. Method: 110 inpatients with schizophrenia and a history of physical assaults were included in a randomized double-blind 12-week study. Fasting glucose, cholesterol and triglycerides were collected at baseline and at the end of the study. Ninety-three patients provided blood samples at baseline and at least at one point after randomization to clozapine (N = 34), olanzapine (N = 31) or haloperidol (N = 28). Results: There were significant differences among the three medication groups in weight gain and in increases in blood lipids and glucose. Patients on haloperidol showed no increase on any of these parameters. Patients on olanzapine gained the most weight, but patients on clozapine had the greatest increases in cholesterol, triglyceride, and glucose. An effect of ethnicity was observed, as African-American patients were more likely to develop metabolic abnormalities than other ethnic groups, especially on clozapine. Conclusions: In this prospective randomized trial, clozapine and olanzapine were associated with weight gain. Clozapine was associated with increases in both lipids and glucose. This effect was most prominent in the African-American patients.

Original languageEnglish
Pages (from-to)95-102
Number of pages8
JournalSchizophrenia Research
Volume110
Issue number1-3
DOIs
Publication statusPublished - May 2009

Fingerprint

olanzapine
Clozapine
Haloperidol
Weight Gain
Inpatients
Glucose
Lipids
African Americans
Blood Glucose
Schizophrenia
Triglycerides
Cholesterol
Metabolome
Random Allocation
Lipid Metabolism
Ethnic Groups

Keywords

  • Aggression
  • Clozapine
  • Ethnicity
  • Metabolic reactions
  • Olanzapine

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Weight gain, metabolic parameters, and the impact of race in aggressive inpatients randomized to double-blind clozapine, olanzapine or haloperidol. / Krakowski, Menahem; Czobor, P.; Citrome, Leslie.

In: Schizophrenia Research, Vol. 110, No. 1-3, 05.2009, p. 95-102.

Research output: Contribution to journalArticle

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