Effects of ziprasidone and olanzapine on body composition and metabolic parameters: an open-label comparative pilot study

Abstract

BackgroundIn contrast to olanzapine, ziprasidone has been reported to cause minimal or no weight gain. This study aimed to compare the effects of ziprasidone and olanzapine on weight, body composition, appetite, resting energy expenditure, substrate oxidation, and metabolic parameters in adults with schizophrenia or other psychotic disorders.MethodsTwenty adults with schizophrenia or other psychotic disorders were randomized 1:1 to ziprasidone 20–160 mg/day or olanzapine 5–20 mg/day for 12 weeks. The mean doses during the 12-week study period were 109(range: 65–140) mg/day for ziprasidone and 11.6(range: 8.2–15.5) mg/day for olanzapine. Body weight, appetite, body composition, resting energy expenditure, and metabolic parameters were measured before and after drug treatment. Outcome measurements before and after medication were compared, and ziprasidone- and olanzapine-treated patients were compared.ResultsAfter 12 weeks, olanzapine-treated patients showed significant weight gain, particularly fat gain, with increased low density lipoprotein-cholesterol and decreased high density lipoprotein-cholesterol concentrations. In contrast, ziprasidone-treated patients showed no significant weight gain with increased high density lipoprotein-cholesterol concentration.ConclusionsZiprasidone was associated with a lower propensity for weight gain and central fat deposition than olanzapine. Studies in larger patient samples are required to confirm these results.

Updating the Comparative Evidence on Second‐Generation Antipsychotic Use With Schizophrenia

“…We included a total of 278 RCTs (see flow diagram in the online supplement); one systematic review of 138 trials (N=47,189) ( 17 ) and 24 additional trials (N=6,672) ( 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ) for SGAs versus other SGAs, and one systematic review of 111 trials (N=118,503) ( 45 , 46 ) and five additional trials (N=1,055) ( 35 , 47 , 48 , 49 , 50 ) for FGAs versus SGAs. The two systematic reviews also included 33 cohort studies (N =652,505) ( 17 , 45 , 46 ).…”

Comparison of Efficacy and Safety Between Low-Dose Ziprasidone in Combination With Sertraline and Ziprasidone Monotherapy for Treatment-Resistant Patients With Acute Exacerbation Schizophrenia: A Randomized Controlled Trial

“…Ziprasidone is an atypical antipsychotic drug which exerts a combined 5-HT and dopamine receptor antagonist effects ( Seeger et al, 1995 ). Additionally, ziprasidone causes the least amount of weight gain and metabolic complications compared to other atypical antipsychotics ( Park et al, 2013 ). Previous clinical trials support that treatment by typical dose of ziprasidone is effective for over 1 year of maintenance therapy for patients with SZ and is accompanied by low rates of both weight gain and metabolic abnormalities ( Loebel et al, 2007 ).…”

The Effects of Antipsychotic Drugs (Olanzapine and Risperidone) on Body Weight, Body Fat Percentage and Lipid Profiles of Patients with Psychotic Illness

“…Factors that could influence the side effect of APDs in inducing body weight gain among patients include its dosage and the demographic characteristics of patients 23 . Olanzapine has been known to be a dose-dependent drug, but the effects of Risperidone are less well known 24,25,26,27 . Demographic characteristics such as age, gender and appetite were discussed to give a clearer picture on the confounding factors that could predict the body weight gain among patients 28 .…”