Efficacy And Effect On Metabolism Of Olanzapine And Risperidone In Patients With Schizophrenia

Objective : To explore the efficacy and effect of olanzapine and risperidone on the metabolism in schizophrenia with or without lipid abnormality.Methods : Collect hospitalized schizophrenia that have never received treatment from Jining Psychiatric Prevention Hospital on January 1, 2015 to February 29, 2016. 44 cases were collected with lipid abnormality(according to the 2007 China Guidelines on Prevention and Management of Lipid Abnormality), including taking olanzapine treatment group of 19 people and taking risperidone group of 25 people. 94 cases were collected without lipid abnormality, including taking olanzapine treatment group of 43 people and taking risperidone group of 51 people. Compare the two groups of fasting blood glucose, triglycerides, total cholesterol, HDL, LDL and lipoprotein a before and after olanzapine or risperidone treatment. Meanwhile, compare the difference in efficacy(based on the PANSS score).Results:1.After olanzapine treatment, the triglycerides was increased( P =0.017) and the differences were statistically significant in lipid abnormality group.2. After risperidone treatment, the fasting blood glucose was decreas ed(P=0.011), the triglycerides was increased(P=0.026) and the differenceswere both statistically significant in lipid abnormality group.3.In lipid abnormality group, after olanzapine and risperidone treatme nt, the differences of fasting blood glucose, triglycerides, total cholesterol,high density lipoprotein, low-density lipoprotein and lipoprotein a were not statistically significant.4. After olanzapine treatment, the fasting blood glucose was decrease d(P=0.000), the triglycerides was increased(P=0.000), the high-density lipo protein was decreased(P=0.044) and the low-density lipoprotein was incre ased, the differences were all statistically significant in non-lipid abnorma lity group. The differences of total cholesterol and lipoprotein a were not statistically significant.5. After risperidone treatment, the fasting blood glucose was decreas ed(P=0.021), the triglycerides was increased(P=0.000), the high-density lip oprotein was decreased(P=0.001) and the differences were statistically sig nificant in non-lipid abnormality group.6. After olanzapine or risperidone treatment, the differences of lipid abnormality group and non-lipid abnormality group in PANSS score, PA NSS-Positive score, PANSS-Negative score and PANSS-General score wer e not statistically significant.7.In lipid abnormality group, the differences after olanzapine and ris peridone treatment in PANSS score, PANSS-Positive score, PANSS-Negati ve score and PANSS-General score were not statistically significant. In n on-lipid abnormality group, the PANSS-General score after olanzapine treatment was lower than risperidone treatment and the differences were stat istically significant(P=0.020).Conclusions : The influence of olanzapine and risperidone on the schizophrenia with or without lipid abnormality was different. 1. The triglycerides of schizophrenia with lipid abnormality was increased after olanzapine or risperidone treatment, and the fasting blood glucose was decreased after risperidone treatment. 2. The fasting blood glucose and the high-density lipoprotein were decreased after olanzapine or risperidone treatment and the triglycerides was increased. After the olanzapine treatment,the low-density lipoprotein was increased. 3. The PANSS scores after olanzapine or risperidone treatment have no significant difference between non- lipid abnormality group and lipid abnormality group. 4. There was no significant difference after olanzapine or risperidone treatment of patients with lipid abnormality. 5. The difference in improving the positive symptoms and negative symptoms were not significant between olanzapine and risperidone treatment of patients with non- lipid abnormality, but the general pathological symptoms, olanzapine treatment was better than the risperidone treament.