Switching to aripiprazole or ziprasidone may enhance weight and different cardiometabolic outcomes in sufferers with critical psychological sickness, in response to a scientific evaluation and meta-analysis publishes on-line in Schizophrenia Bulletin.
“Weight problems and antagonistic metabolic outcomes in sufferers with extreme psychological sickness are clinically important however probably preventable,” researchers defined within the examine goal. “Importantly, the proof for switching to antipsychotics to scale back cardiometabolic burden is unclear.”
To analyze weight and metabolic modifications after switching antipsychotic medicines, in contrast with staying on an antipsychotic, researchers meta-analyzed 59 research, 40% of which had been rated prime quality.
Change-versus-stay meta-analyses, which had been solely potential for aripiprazole and olanzapine, revealed that aripiprazole considerably decreased weight, by 5.52 kilograms. Switching to aripiprazole additionally considerably decreased fasting glucose by 3.99 mg/dl and triglycerides by 31.03 mg/dl. Conversely, olanzapine considerably elevated weight, by 2.46 kilograms, researchers reported. For each antipsychotics, dropout and psychosis scores had been related between swap and keep teams.
Earlier than-to-after swap meta-analyses had been carried out for aripiprazole, amisulpride, clozapine, lurasidone, olanzapine, paliperidone/risperidone, quetiapine, and ziprasidone. Researchers discovered aripiprazole was related to a weight lack of 1.96 kilograms and ziprasidone with a lack of 2.22 kilograms. Olanzapine and clozapine, in the meantime, had been related to weight achieve of two.71 kilograms and a pair of.80 kilograms, respectively. Switching to amisulpride, paliperidone/risperidone, quetiapine, or lurasidone weren’t related to any important weight or different cardiometabolic modifications, in response to the examine.
“Though switching to a special antipsychotic, notably aripiprazole and ziprasidone, could result in weight reduction, these advantages have to be weighed in opposition to any potential dangers of antagonistic drug reactions or deterioration in psychotic signs,” a Psychiatric Information Alert article quoted from the paper. “[S]witching antipsychotics in psychiatrically steady sufferers could threat relapse and detrimental penalties for a minimum of some sufferers.”
Siskind D, Gallagher E, Winckel K, et al. Does switching antipsychotics ameliorate weight gain in patients with severe mental illness? A systematic review and meta-analysis. Schizophrenia Bulletin. 2021 February 6;[Epub ahead of print].