Metabolic changes during clozapine or olanzapine treatment in paranoid schizophrenic patients

Saulė Starkauskaitė1, Erikas Vasiliauskas1

1Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania

Abstract: World Health Organization describes schizophrenia as one of the top leading cause of disability in young adults worldwide. The most effective treatment so far for paranoid schizophrenia is atypical antipsychotics. Despite the effectiveness, chronic atypical antipsychotics use is associated with many side effects. Especially clozapine and olanzapine may contribute to the development of hypertension, obesity and type 2 diabetes.

Aim: The aim was to investigate association between use of clozapine, olanzapine and the prevalence of type 2 diabetes, hypertension and overweight.

Methods: In this retrospective review study, we reviewed medical records of inpatients with paranoid schizophrenia, that received treatment in private psychiatric clinic. The study group consisted of 85 patients, that received treatment with clozapine or olanzapine. The control group consisted of 35 patients taking other atypical antipsychotics than clozapine or olanzapine. The prevalence of type 2 diabetes, hypertension, obesity, average duration of disease, age and gender distribution were investigated between these two groups. The confidentiality agreement ensured the anonymity of the patient data.

Results: The prevalence of overweight was higher in our study group (68,6%) than in control group (58,8%,), even though observed differences were statistically insignificant (p=0,409). Patients receiving olanzapine or clozapine showed lower rate of hypertension 8,6% compared to control group 8,6%, observed difference was insignificant (p=0,516). Type 2 diabetes was more common in our study group 10,6%, than in control group 8,6%, this difference was also statistically not significant (p=0,516).

Conclusions:  In our retrospective study, the prevalence of overweight and type 2 diabetes were more common in patients taking olanzapine or clozapine. Hypertension was less common in our study group compared to control group, even though differences were statistically not significant in all observed cases.

Key words: schizophrenia, clozapine, olanzapine, type 2 diabetes, hypertension.