Ziprasidone versus Olanzapine in the weight gain associated with the treatment of schizophrenia: A six-month double-blind randomized parallel group study

Abstract

-Background and Objectives: Previous data from safety analysis indicate that olanzapine can result in substantial weight gain, while no change has been observed with ziprasidone. Obesity may be a threat to health and cause subjects to discontinue their antipsychotic medication. To further evaluate the differential effects of ziprasidone and olanzapine on weight gain, a study was carried out having body weight as the primary efficacy endpoint.Methods: A six-month randomized, double-blind, parallel study was carried out in male and female subjects aged 18-70 years with a primary diagnosis of schizophrenia (DSM-IV-TR) and a clinical condition requiring treatment initiation with a new antipsychotic, ziprasidone or olanzapine 1:1, to assess treatment-related weight changes. Fifty patients were included. Efficacy outcomes were assessed at baseline and at weeks 1, 4, 12, 18 and 24. The primary efficacy endpoint was the percent change from baseline in body weight at week 24. Safety was also assessed.Results: At week 24, there was a significantly greater increase in body weight (7.5%, p < 0.0001) in patients treated with olanzapine than in those treated with ziprasidone and EFFECTS OF ZIPRASIDONE VERSUS OLANZAPINE IN WEIGHT GAIN 249

Long‐term effectiveness of oral second‐generation antipsychotics in patients with schizophrenia and related disorders: a systematic review and meta‐analysis of direct head‐to‐head comparisons

“…Altogether, we included 63 reports (59 randomized studies) with 45,787 participants (median: 255 participants/study, range: from 12 to 18,154) (Table ). The mean age of the population was 37.6±7.0 years; 62.1±13.3% were male and 61.1±28.8% were white.…”

Cost-effectiveness of atypical antipsychotics for the treatment of schizophrenia

“…Two studies, conducted in Mexico and Canada and sponsored by Pfizer, considered ziprasidone dominant over olanzapine (Mould-Quevedo et al, 2009;McIntyre et al, 2010) and one study found ziprasidone to be less effective and less costly, with ICER that favored olanzapine (O'Day et al, 2013). There is consistent evidence that olanzapine provokes more metabolic effects than other antipsychotic drugs (McQuade et al, 2004;Breier et al, 2005;Lieberman et al, 2005;Chiu et al, 2006;Rosenheck et al, 2006;Fleischhacker et al, 2009;Kane et al, 2009;Alvarez et al, 2012;Ou et al, 2013;Zhang & Lan 2014). In general, analyses that focus on the metabolic profile of the drugs tend to disfavor olanzapine in comparison to other medication (Colombo et al, 2008;McIntyre et al, 2010).…”

Economic evaluation of antipsychotics for the treatment of schizophrenia: a systematic review

“…One of them found results that favor risperidone (Cooper et al, 2008) and the other slightly favors risperidone, but clarifies that no statistical difference was found (De Ridder & De Graeve, 2009). The metabolic side effects of olanzapine are widely known and there is evidence that they are more prevalent with olanzapine than with other drugs (Rosenheck et al, 2003;Mcquade et al, 2004;Breier et al, 2005;Lieberman et al, 2005;Chiu et al, 2006;Fleischhacker et al, 2009;Kane et al, 2009;Alvarez et al, 2012;Ou et al, 2013;Zhang & Lan, 2014). When the developed model depends highly of metabolic effects, olanzapine tend to be in disadvantage when compared to aripiprazole, risperidone and ziprasidone (Colombo et al, 2008;Mcintyre et al, 2010).…”