Insulin resistance induced by olanzapine and other second-generation antipsychotics in Chinese patients with schizophrenia: a comparative review and meta-analysis

Yu, Liangyu; Wu, Sanlan; Deng, Yahui; Lei, Juan; Li-xiu, YU; Li, Weiyong

doi:10.1007/s00228-019-02739-5

Cited by 10 publications

(3 citation statements)

References 22 publications

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“…In a previous network meta-analysis evaluating changes in glucose levels from baseline that included 47 randomized trials, the authors found that among the antipsychotics included in our review, only olanzapine was associated with a significant increase in glucose compared to placebo and only ziprasidone and risperidone were associated with significantly better results than olanzapine; when ranked using the surface under the cumulative ranking values, ziprasidone was ranked as the best and clozapine and olanzapine as the worst antipsychotics regarding their impact on serum glucose levels [ 55 ]. Yu et al [ 56 ], in a meta-analysis of 14 studies in Chinese patients, found a higher likelihood of insulin resistance with olanzapine than with risperidone, ziprasidone, or aripiprazole. Another meta-analysis of studies conducted in healthy volunteers suggested that the occurrence of insulin resistance depends on treatment length [ 57 ], reinforcing the need for long-term studies on antipsychotic-induced metabolic disorders.…”

Section: Discussionmentioning

confidence: 99%

Real-World Data on the Adverse Metabolic Effects of Second-Generation Antipsychotics and Their Potential Determinants in Adult Patients: A Systematic Review of Population-Based Studies

et al. 2021

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Introduction: To assess the risk of occurrence and potential determinants of metabolic disorders in adult patients treated with second-generation antipsychotics (SGAs) under real-world practice conditions. Methods: MEDLINE, EMBASE, and PsycInfo were searched in July 2019 from database inception. We included population-based, longitudinal, comparative studies that report the results of the outcomes of interest for adult participants, including diabetes, ketoacidosis, hyperosmolar hyperglycemic state, weight gain/ obesity, dyslipidemia, hypertension, and metabolic syndrome. Two reviewers independently extracted data on the study design, study quality, and study outcomes. Results: We included 40 studies. Most studies showed that clozapine and olanzapine were associated with an increased likelihood of developing diabetes, while the results for risperidone and quetiapine were mixed. Although less well studied, ziprasidone and aripiprazole appeared to not be associated with the occurrence of diabetes. Information on antipsychotic-induced weight gain/obesity is extremely scarce. Regarding dyslipidemia, aripiprazole was not associated with an increased likelihood of developing dyslipidemia, clozapine was associated with an increased likelihood of developing dyslipidemia, and risperidone, olanzapine, quetiapine, and ziprasidone showed mixed results. Two studies suggested an association between ziprasidone and the occurrence of hypertension. Several studies found that the occurrence of a metabolic disorder acted as a risk factor for the development of other metabolic disorders. We did not find information on brexpiprazole, cariprazine, or lurasidone, and data on any long-acting SGA were lacking. Conclusion: Although there are relevant differences among SGAs concerning the risk of metabolic disorders,

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Section: Discussionmentioning

confidence: 99%

Real-World Data on the Adverse Metabolic Effects of Second-Generation Antipsychotics and Their Potential Determinants in Adult Patients: A Systematic Review of Population-Based Studies

et al. 2021

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“…Evidence for weight gain was found for clozapine, zotepine, olanzapine, and sertindole, iloperidone, quetiapine, risperidone and paliperidone, and brexpiprazole. SGA are also associated with glucose abnormalities and development of DM2 (9,(20)(21)(22)(23). Pillinger et al (24), performed a large metaanalysis to compare and rank antipsychotics based on their metabolic side-effects and to identify predictors of antipsychoticinduced metabolic dysregulation.…”

Section: Introductionmentioning

confidence: 99%

Clinical, Biochemical and Genetic Variables Associated With Metabolic Syndrome in Patients With Schizophrenia Spectrum Disorders Using Second-Generation Antipsychotics: A Systematic Review

et al. 2021

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Background: Individuals with severe mental illness experience increased morbidity and mortality compared to the general population. Adverse effects of antipsychotics, including weight gain, may contribute to the development of metabolic syndrome (MetS), which is associated with increased risks of all-cause and cardiovascular disease mortality. We aim to provide a comprehensive overview of clinical, biochemical and genetic factors associated with MetS among patients with schizophrenia spectrum disorders using second-generation antipsychotics (SGA).Methods: A literature search was performed in Pubmed and Embase to identify all cohort studies, cross-sectional studies and clinical trials investigating associations with MetS in patients with schizophrenia spectrum disorders using SGAs. We extracted and enumerated clinical, biochemical and genetic factors reported to be associated with MetS. We defined factors associated with MetS as factors being reported as associated with MetS in two or more studies.Results: 58 studies were included in this review (n = 12,123). In total, 62 factors were found to be associated with increased risk of MetS. Thirty one out of 58 studies investigated factors that were reported as associated with MetS in two or more studies. With regard to clinical factors, we found gender, higher age, concomitant use of mood stabilizers, higher baseline and current BMI, earlier SGA exposure, higher dose, longer duration of treatment, psychosis and tobacco smoking to be significantly associated with MetS. Furthermore, the biochemical factors hypo-adiponectinemia, elevated levels of C-reactive protein (CRP) and higher white blood cell (WBC) count were identified as factors associated with MetS. Among pharmacogenetic factors, the rs1414334 C-allele of the HTR2C-gene was associated with MetS in patients using SGA.Conclusion: In this systematic review investigating clinical, biochemical and genetic factors associated with MetS in patients using SGAs we found that higher age, higher baseline BMI, higher current BMI and male as well as female gender were positively associated with MetS across all antipsychotics. This study may set the stage for the application of clinical, biochemical and genetic factors to predict the risk of developing MetS in patients using SGAs. Future research is needed to determine which patients using SGAs are at risk to develop MetS in clinical practice.

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“…Schizophrenia is a chronic, serious mental disorder involving abnormal feelings, perceptions, emotions, and behaviors of people. [ 1 ] As the disease progresses, patients are in a closed inpatient environment for a long time, withdraw from society, and suffer from a decline in their life, study, and interpersonal skills, often accompanied by cognitive disorders. This disease not only affects prognosis but also causes a serious burden to society and patients’ families.…”

Section: Introductionmentioning

confidence: 99%

Clinical study of dance art therapy on hospitalized patients with chronic schizophrenia

Kong,

Min,

Zhu

et al. 2024

Medicine

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Background: To explore the effect of dance art on the treatment of hospitalized patients with chronic schizophrenia. Methods: In a prospective randomized controlled study conducted from June 2019 to June 2020, 120 patients from Shanghai Pudong New Area Mental Health Center were divided into intervention (n = 60) and control (n = 60) groups using a random number table. Control patients received standard drug treatment and nursing care, while the intervention group underwent dance art therapy sessions for 90 minutes twice weekly, in addition to standard care. Treatment outcomes after 6 and 12 weeks were measured using the positive and negative symptom scale (PANSS), Wisconsin Card Sorting Test (WCST), Montreal Cognitive Assessment Scale (MoCA), and body mass index (BMI). Results: This study involved 120 male patients with chronic schizophrenia, aged 30 to 60 years. After 6 and 12 weeks, the intervention group showed a greater reduction in PANSS scores (intervention group: from 49.02 ± 2.53 to 37.02 ± 1.83, control group: from 49.08 ± 2.59 to 44.91 ± 2.35, P < .05). In the WCST, the intervention group exhibited a higher increase in classification completion and correct answers, and a greater decrease in errors (P < .05). MoCA scores improved significantly in the intervention group compared to the control group (P < .05). BMI decreased in both groups, with a more pronounced reduction in the intervention group (intervention group: from 26.47 ± 1.05 kg/m² to 22.87 ± 0.73 kg/m², control group: from 26.50 ± 1.03 kg/m² to 26.22 ± 0.80 kg/m², P < .05). Conclusion: Based on routine drug treatment and routine nursing care, dance art has a better clinical effect in treating hospitalized patients with chronic schizophrenia, which can improve cognitive function, alleviate clinical symptoms, and reduce BMI.

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Insulin resistance induced by olanzapine and other second-generation antipsychotics in Chinese patients with schizophrenia: a comparative review and meta-analysis

Cited by 10 publications

References 22 publications

Real-World Data on the Adverse Metabolic Effects of Second-Generation Antipsychotics and Their Potential Determinants in Adult Patients: A Systematic Review of Population-Based Studies

Real-World Data on the Adverse Metabolic Effects of Second-Generation Antipsychotics and Their Potential Determinants in Adult Patients: A Systematic Review of Population-Based Studies

Clinical, Biochemical and Genetic Variables Associated With Metabolic Syndrome in Patients With Schizophrenia Spectrum Disorders Using Second-Generation Antipsychotics: A Systematic Review

Clinical study of dance art therapy on hospitalized patients with chronic schizophrenia

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