The metabolic side effects of 12 antipsychotic drugs used for the treatment of schizophrenia on glucose: a network meta-analysis

Abstract

BackgroundAntipsychotics have serious metabolic side effects on blood glucose. However, the comparative influence of these drugs on blood glucose levels has not been comprehensively evaluated. We conducted a network meta-analysis to create a hierarchy of the side effects of 12 antipsychotic drugs on changes in blood glucose levels.MethodsA systematic search of the PubMed, EMBASE and Cochrane databases (last search June 2016) was conducted to identify studies that reported randomized controlled trials (RCTs) comparing changes in blood glucose levels between patients receiving one of 12 antipsychotic drugs or a placebo for the treatment of schizophrenia or related disorders. The studies we searched were limited to those published in English. Two reviewers independently extracted data. The primary outcome of interest was changes in fasting glucose levels.ResultsWe included 47 studies with 114 relevant arms. Of the antipsychotic drugs, only olanzapine was associated with significantly increased glucose levels compared to a placebo (mean difference (MD) = 3.95, 95% confidence interval (CI) = 0.14 to 7.76). Moreover, olanzapine was associated with a significantly greater change in the glucose levels than ziprasidone (MD = 5.51, 95% CI = 1.62 to 9.39), lurasidone (MD = 5.58, 95% CI = 0.53 to 10.64) or risperidone (MD = 3.05, 95% CI = 0.87 to 5.22). Ziprasidone and lurasidone were associated with minimal glucose changes compared to the other antipsychotics.ConclusionsOlanzapine was associated with a significantly greater change in blood glucose levels than ziprasidone, lurasidone, risperidone or placebo treatment. The application of a hierarchy of glucose metabolism-related side effects may help clinicians tailor the choice of antipsychotic drug to meet the needs of individual patients.Electronic supplementary materialThe online version of this article (10.1186/s12888-017-1539-0) contains supplementary material, which is available to authorized users.

Hubungan Pemberian Terapi Antipsikotik terhadap Kejadian Efek Samping Sindrom Ekstrapiramidal pada Pasien Rawat Jalan di Salah Satu Rumah Sakit di Bantul, Yogyakarta

“…5 Pemberian antipsikotik dapat menyebabkan respon yang buruk dan efek samping seperti gejala ekstrapiramidal, 7,8 sindrom metabolik, dan juga kenaikan berat badan yang akan memperburuk kondisi pasien. 9,10 Oleh karena itu, praktisi sering kali melakukan pergantian terapi 11,12 yang tidak efektif yaitu berdasarkan trial dan error 13 sehingga pasien mengalami banyak kejadian yang tidak diinginkan, seperti efek rebound dan kekambuhan. 14,15 Kejadian efek samping terbanyak yang dialami pasien skizofrenia pada penelitian Julaeha et al (2016) adalah efek samping EPS, kemudian disusul dengan hipotensi dan kenaikan enzim SGPT/SGOT.…”

Schizophrenia in The Context of Mental Health Services in Palestine: a literature review

“…Antipsychotic medication adherence and satisfaction were also assessed in patients with Antipsychotic medications cause serious side effects, including metabolic syndrome (MS) [37].…”

Olanzapine for the Prevention and Treatment of Chemotherapy-Induced Nausea and Vomiting

“…Оланзапин также может оказывать влияние на метаболические процессы в организме. Это повышает риск развития и усугубления течения гиперлипидемии и сахарного диабета [31,32]. Описаны также случаи электролитных нарушений на фоне применения препарата [33].…”