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Assistant Professor of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
Assistant Professor of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran PO Box 14155/6451, Postal Code: 14174, fax +98-21-66461178, dashtis{at}sina.tums.ac.ir
Student of Pharmacy, School of Pharmacy, Tehran University of Medical Sciences
Associate Professor of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences
Published Online, April 10, 2007. www.theannals.com, DOI 10.1345/aph.1H669
Methods. Seventy adults with schizophrenia who were started on risperidone entered this 8 week, cross-sectional study. Exclusion criteria included receipt of electroconvulsive therapy within 6 months or any medications affecting lipid profile within 2 weeks prior to the initiation of the study; diabetes mellitus, dyslipidemia, or cardiovascular disorders; and pregnancy or breast-feeding. All patients/guardians gave informed consent.
Weight, body mass index (BMI), and fasting TC and TG levels were measured at baseline and at week 8. Data were analyzed using paired t-test and Pearson correlation test.
Results. Forty-seven patients between 19 and 76 years of age completed the study. Twenty-three patients dropped out of this study—18 due to being discharged from the hospital and 5 because of receiving medications with potential effects on lipid levels before week 8.
Patients' baseline mean weight and BMI increased from mean ± SD 64.60 ± 12.96 kg and 22.47 ± 4.30 kg/m2 to 66.22 ± 12.57 kg (p < 0.001) and 23.05 ± 4.19 kg/m2 (p < 0.001) at week 8, respectively.
Overall, TC and TG levels did not change significantly during this study; TC concentrations significantly decreased in 23 (48.9%) and increased in 24 (51.1%) subjects, while TG levels significantly decreased in 25 (53.2%) and increased in 22 (46.8%) patients (Table 1).
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Significant inverse correlations were found between baseline TC levels and changes in serum TC (r = –0.37; p = 0.01) and between baseline TG concentrations and changes in serum TG after 8 weeks of treatment with risperidone (r = –0.47; p = 0.001).
Age, sex, and weight had no effect on the changes in serum TC or TG levels.
Discussion. Clozapine and olanzapine have been reported to increase TG levels more than risperidone does.1,2 One report showed that TG levels in patients receiving clozapine decreased after therapy was switched from clozapine to risperidone.4 Our study showed that overall, risperidone had no significant effect on TC and TG levels; however, significant decreases in both TC and TG levels were observed in about half of the patients, while other subjects showed significant increases in these levels. Of note is the fact that patients with lower TC or TG levels at baseline showed increases in these concentrations after receiving risperidone, while subjects with higher TC or TG levels at baseline showed decreases in these levels after receiving risperidone for 8 weeks. Although factors including baseline body weight, age, sex, and duration of treatment have been reported to cause weight gain in patients receiving risperidone,5 age, sex, and weight did not affect the lipid profile of patients on risperidone in our study. Two confounding factors, obesity and diet, were taken into consideration. None of the patients was obese; in addition, patients received the same diet during the study.
In conclusion, the use of risperidone significantly increased weight and BMI but had no significant effect on TC or TG levels. However, alterations in serum TC and TG levels were inversely related to the baseline levels, indicating that high baseline TC or TG levels may not limit the use of risperidone.
Footnotes
This research was supported by the Tehran University of Medical Sciences and health services grant.
References
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