Sex-differential effects of olanzapine vs. aripiprazole on glucose and lipid metabolism in first-episode schizophrenia

• Published in: Revista de psiquiatria clínica Vol. 46; no. 2; pp. 33 - 39
• Main Authors: Zhou, Xue-Mei, Hu, Mao-Rong, Gong, Mei-Yu, Zou, Xue-Liang, Yu, ZHi-Min
• Format: Journal Article
• Language: English; Portuguese
• Published: Universidade de Sao Paulo, Facultade de Medicina 01.03.2019; Faculdade de Medicina da Universidade de São Paulo
• Subjects: Analysis; Antipsychotic agents; Aripiprazole; Body mass index; Cholesterol; Criminal investigation; Email; Fasting; Glucose; Glucose metabolism; Health; Low density lipoproteins; Medical research; MEDICINE, GENERAL & INTERNAL; Mental health; Mental health services; Olanzapine; Physiological aspects; Psychiatrists; PSYCHIATRY; Schizophrenia; Sex differences (Psychology); Triglycerides; Schizophrenia; olanzapine; aripiprazole; glucose and lipid; sex difference
• ISSN: 0101-6083; 1806-938X; 1806-938X
• DOI: 10.1590/0101-60830000000189

Objective: To compare sex difference in metabolic effect of olanzapine versus aripiprazole on schizophrenia. Methods: A twelve-week prospective open-label cohort study to compare four subgroups according to first-episode schizophrenia patients' type of drug usage and sex: female aripiprazole (n = 11), male aripiprazole (n = 11), female olanzapine (n = 10), and male olanzapine (n = 11) for body mass index, fasting serum triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and fasting glucose. Results: Aripiprazole may be associated with weight gain in female patients with low-baseline weight. Aripiprazole may have an adverse effect of weight and favorable effects of circulating glucose and lipid on female over male schizophrenia patients. The aripiprazole-induced changes in glucose and lipid may be independent of body fat storage, especially for female schizophrenia patients. Olanzapine may have adverse effects of weight, glucose and lipid profiles on female over male schizophrenic patients. Discussion: Our findings fill the gap in knowledge and provide a sex-specific guidance to psychiatrist better tailoring treatment to individual sex-differential characteristics and a key clue to understand the sex-differential mechanism of antipsychotics-induced metabolic dysfunction. ZHou XM et al. / Arch Clin Psychiatry. 2019;46(2):33-9 Keywords: Schizophrenia, sex difference, glucose and lipid, olanzapine, aripiprazole.