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Impact of olanzapine or risperidone treatment on insulin sensitivity in schizophrenia or schizoaffective disorder
Author(s) -
Hardy T. A.,
Henry R. R.,
Forrester T. D.,
Kryzhanovskaya L. A.,
Campbell G. M.,
Marks D. M.,
Mudaliar S.
Publication year - 2011
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/j.1463-1326.2011.01398.x
Subject(s) - olanzapine , risperidone , medicine , endocrinology , insulin , schizoaffective disorder , dopamine antagonist , schizophrenia (object oriented programming) , atypical antipsychotic , insulin resistance , antipsychotic , psychosis , haloperidol , psychiatry , dopamine
Aim: To assess changes in insulin sensitivity in non‐diabetic adults with schizophrenia or schizoaffective disorder treated with olanzapine or risperidone. Methods: One hundred and thirty patients were randomly assigned to 12 weeks double‐blind treatment with olanzapine or risperidone. Insulin sensitivity was measured using a two‐step euglycaemic, hyperinsulinaemic clamp procedure. Whole‐body adiposity was measured using dual‐energy X‐ray absorptiometry. The primary endpoint was the within‐group change from baseline in insulin sensitivity normalized to fat‐free mass ( M ffm / I ) during the clamp procedure's low‐insulin phase, using an analysis of covariance model including the covariate weight change. Results: Forty‐one olanzapine‐treated and 33 risperidone‐treated patients completed baseline and endpoint clamp measurements. Mean M ffm / I during the low‐insulin phase declined 9.0% (p = 0.226) in olanzapine‐treated patients and 13.2% (p = 0.047) in risperidone‐treated patients (between‐group difference p = 0.354). During the high‐insulin phase, M ffm / I declined 10.4% (p = 0.036) in olanzapine‐treated patients and 2.1% (p = 0.698) in risperidone‐treated patients (between‐group difference p = 0.664). Changes in M ffm / I correlated inversely with changes in body weight and adiposity, which were generally higher in olanzapine‐treated patients. Significant within‐group increases in fasting glucose, but not haemoglobin A1c (HbA1c), were observed during olanzapine treatment. The fasting glucose change was not correlated with M ffm / I changes. Conclusions: Small, but statistically significant, decrements in insulin sensitivity were observed in olanzapine‐ and risperidone‐treated patients at 1 of 2 insulin doses tested. Significant increases in fasting glucose and insulin and total fat mass were observed only in olanzapine‐treated patients. Changes in insulin sensitivity correlated significantly with changes in weight or adiposity, but not with changes in glucose.