Serum triglyceride levels in patients treated with clozapine

Relationship between levels of insulin or triglycerides and serum concentrations of the atypical antipsychotics clozapine and olanzapine in patients on treatment with therapeutic doses

“…About 40-60% of the clozapine-and olanzapinetreated patients also had hyperlipidemia, which is in line with findings in other studies (Ghaeli and Dufresne 1996;Gaulin et al 1999;Osser et al 1999;Melkersson et al 2000). However, only levels of triglycerides, but not of cholesterol, were closely correlated to insulin in the two treatment groups.…”

“…In a further study, although we could not show a relationship between insulin levels and the drug serum concentration of olanzapine, patients receiving olanzapine exhibited a significantly higher median insulin level than classical antipsychotic-treated patients, indicating in addition a likely influence of olanzapine on insulin secretion . Moreover, an association between hyperlipidemia and the use of clozapine or olanzapine has been reported by others (Ghaeli and Dufresne 1996;Osser et al 1999). This probable influence of both clozapine and olanzapine on insulin secretion and lipid metabolism may explain the agents' side effects such as the weight gain, lipid abnormalities and diabetes; at the same time, the possibility of a concomitant relationship to the drugs' antipsychotic effect cannot be ruled out (Melkersson et al 1999(Melkersson et al , 2000.…”

“…In the light of our and others recent findings (Ghaeli and Dufresne 1996;Osser et al 1999;Melkersson et al 1999Melkersson et al , 2000, the aim of the present study was primarily to examine potential relationships between insulin or other hormones related to glucose-insulin homeostasis or lipids, and drug serum concentrations in patients on therapeutic doses of clozapine or olanzapine, in order to find out whether previous results could be confirmed in a new independent patient group. The object was also to study potential correlations between hormones related to glucose-insulin homeostasis and insulin in patients treated with clozapine or olanzapine.…”

Acute clozapine exposure in vivo induces lipid accumulation and marked sequential changes in the expression of SREBP, PPAR, and LXR target genes in rat liver

“…The clozapine-induced transcriptional activation of hepatic lipid biosynthesis in rats is in line with numerous clinical studies, demonstrating that clozapine treatment is associated with marked increases in triacylglycerol serum concentrations (Gaulin et al 1999;Ghaeli and Dufresne 1996;Henderson et al 2000;Spivak et al 1998). Patients using clozapine also have increased risk of developing obesity, impaired glucose tolerance, and hypertension (Allison et al 1999;Lamberti et al 2006;Timar et al 2000).…”

Insulin and leptin levels in patients with schizophrenia or related psychoses - a comparison between different antipsychotic agents

“…3 The chemical structure of clozapine (a) resembles that of olanzapine (b) apart from the fact that the clozapine structure is halogenated with a chlorine atom (a→) while olanzapine is not (b) and that the olanzapine molecule includes a thieno ring (b→) in place of the benzo ring of clozapine (a) (Budavari et al 1996) in glycemic control of already diagnosed diabetes after the beginning of clozapine or olanzapine therapies (Short and Nolan 1995;Kostakoglu et al 1996;Popli et al 1997;Ai et al 1998;Wirshing et al 1998;Goldstein et al 1999), two previous studies have pointed to an influence of clozapine on glucose-insulin homeostasis (Yazici et al 1998;Melkersson et al 1999), whereas in olanzapine-treated patients, no comparable studies of glucoseinsulin levels have been carried out. Previous studies have, however, reported elevated blood lipid levels during both clozapine and olanzapine treatments (Ghaeli and Dufresne 1996;Dursun et al 1999;Gaulin et al 1999;Osser et al 1999;Sheitman et al 1999;Spivak et al 1999), which supports the theory that both clozapine and olanzapine may influence glucose-insulin homeostasis by inducing insulin resistance, since hyperlipidemia may be connected with insulin resistance and secondary increased insulin secretion (Olefsky 1997).…”