Head-to-head comparisons of metabolic side effects of second generation antipsychotics in the treatment of schizophrenia: a systematic review and meta-analysis
By C. Rummel-Kluge, Katja Komossa, S. Schwarz, H. Hunger, Franziska Schmid, C. A. Lobos, Werner Kissling, John M. Davis, S. Leucht. Schizophrenia Research, 2010
677 citations recorded by the source corpus.
Objective The metabolic side effects of second-generation antipsychotics (SGA) are serious and have not been compared head to head in a meta-analysis. We conducted a meta-analysis of studies comparing the metabolic side effects of the following SGAs head-to-head: amisulpride, aripiprazole, clozapine, olanzapine, quetiapine, risperidone, sertindole, ziprasidone, zotepine. Method We searched the register of the Cochrane schizophrenia group (last search May 2007), supplemented by MEDLINE and EMBASE (last search January 2009) for randomized, blinded studies comparing the above mentioned SGA in the treatment of schizophrenia or related disorders. At least three reviewers extracted the data independently. The primary outcome was weight change. We also assessed changes of cholesterol and glucose. The results were combined in a meta-analysis. Results We included 48 studies with 105 relevant arms. Olanzapine produced more weight gain than all other second-generation antipsychotics except for clozapine where no difference was found. Clozapine produced more weight gain than risperidone, risperidone more than amisulpride, and sertindole more than risperidone. Olanzapine produced more cholesterol increase than aripiprazole, risperidone and ziprasidone. (No differences with amisulpride, clozapine and quetiapine were found). Quetiapine produced more cholesterol increase than risperidone and ziprasidone. Olanzapine produced more increase in glucose than amisulpride, aripiprazole, quetiapine, risperidone and ziprasidone; no difference was found with clozapine. Conclusions Some SGAs lead to substantially more metabolic side effects than other SGAs. When choosing an SGA for an individual patient these side effects with their potential cause of secondary diseases must be weighed against efficacy and characteristics of the individual patient.
Subfields: Neurology, Psychiatry and Mental health, Toxicology
View Paper: https://www.semanticscholar.org/paper/effed71d68deaacd021015f3fcf6c2d2e36af9ce
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Citations in the corpus
- Prevalence of metabolic syndrome and metabolic abnormalities in schizophrenia and related disorders--a systematic review and meta-analysis. (2013, background): “8 kg in drug-naı̈ve patients after starting antipsychotic treatment in the first 3 months of treatment.(35) No data on differences in MetS rates between patients taking different APs are available.”
- Metabolic and cardiovascular adverse effects associated with antipsychotic drugs (2012, background): “A systematic review and meta-analysis also found that treatment with olanzapine and clozapine produced a greater increase in blood glucose levels than that induced by amisulpride, aripiprazole, quetiapine, risperidone and ziprasidone”
- World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia, Part 1: Update 2012 on the acute treatment of schizophrenia and the management of treatment resistance (2012, background): “In this metaanalysis clozapine and quetiapine resulted in signifi - cantly less use of antiparkinsonian medication, but these two drugs have not been compared directly (Rummel-Kluge et al. 2010a).”
- Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder (2015, result): “among antipsychotics, that has been confirmed in different studies and meta-analyses (11,23-33).”