The Efficacy And Metabolic Safety Of Glucose And Lipid Of Ziprasidone And Olanzapine In The Treatment Of First-episode Schizophrenia

Objective:To compare the efficacy and safety of Ziprasidone and Olanzapine in the treatment of first-episode schizophrenic patients; To compare the effects of ziprasidone and olanzapine on body weight and glucose and lipid metabolism in first-episode schizophrenia; To evaluate the efficacy of health education on medication compliance in first-episode schizophrenic patients.Methods:Eighty first-episode schizophrenia patients were randomly assigned to receive ziprasidone or Olanzapine for6weeks. The Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression-severity scale (CGI-SII) were used to assess the efficacy of ziprasidone and olanzapine and measured at baseline, week2, week4and week6. The primary outcomes for efficacy were the total score and rate change of PANSS and CGI-SII. The remission and response rates were used as the second efficacy outcomes. The weight was measured at baseline, week2, week4and week6. Fasting blood glucose (FBS), fasting insulin (INS), high-density lipoprotein (HDL), total-cholesterol (CHOL) and triglycerides (TG) were measured at baseline and week6. Body mass index (BMI) and insulin resistance index (IRI) were calculated. The adverse events (AEs) were recorded by the investigator. All patients received mental health education at each follow-up visit. The compliance of ziprasidone and olanzpine was evaluated at each follow-up visit.Results:Of the80patients,79patients (39for ziprasidone and40for olanzapine) completed the6-week treatment trial. The mean dosage of ziprasidone and olanzapine were127.5mg/d and19.1mg/d, respectively. The changes of the total score of PANSS and CGI-SII and remission and response rates did not differ between the two groups. Zziprasidone could induce more extrapyramidal side effects than olanzapine(P<0.05). No serious AEs were observed. The increases of body weight, FBS, INS,and LDL in the olanzapine group were significantly greated than those in the ziprasidone group. HDL, CHOL, and TG increased in the two groups without groups difference. Mental health education could improve the patients compliance of ziprasidone and olanzapine.Conclution:Ziprasidone and olanzapine could use to treat first-episode schizophrenia safely with the same efficacy. Ziprasidone could cause more extrapyramidal side effects Than olanzapine, but olanzapine could cause more weight and glucose and lipid dysfunction. Mental health education can significantly improve medication compliance in first-episode schizophrenia patients.