The Study About Effects Of Topiramate On Weight Gain And Glycolipid Metabolism Dysfunction Induced By Olanzapine

ObjectiveBy monitoring the body weight,BMI,blood glucose,blood lipids,insulin and other indicators of patients after medication,the intervention effect of topiramate on olanzapine-induced weight gain and abnormal glucose and lipid metabolism was explored,and the effects of drug side effects and antipsychotic effects were evaluated.Discuss whether it can be used as a clinical intervention drug for atypical antipsychotics(AAPs)-induced body mass increase and glucose and lipid metabolism disorders Methods(1)50 schizophrenics were randomly divided into two groups.25 patients in the study group received olanzapine and topiramate(hereinafter referred to as OLZ + TPM group),25 patients in the control group received olanzapine and placebo(hereinafter referred to as OLZ group alone),and the experimental period was 12 weeks.(2)Measurement of body weight index: height,weight,waist circumference,hip circumference and other body weight indexes were measured before treatment and at the end of the 2nd,4th,8th and 12 th weeks in each group,and body mass index(BMI)and waist-to-hip ratio(WHR)were calculated;(3)Biochemical indexes: fasting blood glucose(FBG),serum triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),insulin(FINS)and other biochemical indexes were detected before and at the end of 4 and 12 weeks.(4)Evaluation of efficacy and adverse reactions: the efficacy was evaluated before treatment and at the end of the 4th and 12 th week,and the adverse reactions were evaluated before treatment and at the end of the 2nd,4th,8th and 12 th week.Results(1)There was no significant difference in age,gender,course of disease,family history,body mass index and biochemical indexes between the two groups(χ 2 > 0.05 or P > 0.05).(2)After 12 weeks of treatment,the body weight and BMI of the two groups were increased.The WHR of the OLZ + TPM group are also increased,but the WHR of the OLZ + TPM group did not change significantly.The body weight increase rate of the OLZ + TPM group were over7%,which was significantly higher than that of the OLZ + TPM group(18%)(P < 0.01).The body weight and BMI of the OLZ + TPM group at the 4th,8th and 12 th weekend were lower than that of the OLZ group(P<0.05).The WHR of the OLZ + TPM group at the 12 th weekend was lower than that of the OLZ group(p<0.05).(3)After treatment,FBG,TG,TC,LDL-C and fins were increased,HDL-C was decreased.The increase of FBG,TG,LDL,INS in olz group was higher than that in olz + TPM group(P<0.05)(4)There was no significant difference in the scores of positive and negative symptoms between the two groups(P<0.05)(5)There was no significant difference in the incidence of adverse reactions between the two groups(P > 0.05)Conclusion TPM can control the weight gain caused by OLZ and reduce the levels of FBG,TG,LDL and ins.TPM can be used as an effective assistant drug for OLZ,which can relieve the psychotic symptoms more quickly.It can also be used as a method to intervene the weight gain and glycolipid metabolism disorder caused by olanzapine.