Prospective 8-week trial on the effect of olanzapine, quetiapine, and aripiprazole on blood glucose and lipids among individuals with first-onset schizophrenia

BACKGROUND Metabolic symptoms induced by antipsychotic medication have been widely documented but there have been few studies comparing the effect of commonly used atypical antipsychotics on blood glucose and lipids among individuals with first-onset schizophrenia. METHODS A total of 150 patients with first-onset schizophrenia were randomized into three groups and each group was treated with olanzapine, quetiapine, or aripiprazole for eight weeks. Blood glucose and lipids (including levels of triglyceride, total cholesterol, low-density lipoprotein, and high-density lipoprotein) were tested at baseline and at the end of the 8 weeks of treatment. RESULTS Fasting blood glucose increased significantly over the 8 weeks in the olanzapine group but not in the quetiapine or aripiprazole groups. Based on a repeated measures analysis of variance, triglyceride levels increased significantly over the 8 weeks of treatment and high-density lipoprotein decreased significantly over the 8 weeks of treatment. The increase in triglyceride in the olanzapine and quetiapine groups was greater than that in the aripiprazole group, and the decrease in high-density lipoprotein was greater in the olanzapine and quetiapine groups than in the aripiprazole groups. CONCLUSIONS During the first 8 weeks of treatment of drug-naïve patients with schizophrenia, olanzapine has a greater effect on blood glucose than quetiapine or aripiprazole, and both olanzapine and quetiapine have a greater effect on blood lipids than aripiprazole.