Effect on lipid profiles of switching from olanzapine to another second-generation antipsychotic agent in veterans with schizophrenia.

Effect on lipid profiles of switching from olanzapine to another second-generation antipsychotic agent in veterans with schizophrenia. Research Abstract Details 

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Effect on lipid profiles of switching from olanzapine to another second-generation antipsychotic agent in veterans with schizophrenia. Abstract Text:

Patrick M Garman,L Douglas Ried,Michael A Bengtson,Chienning Hsu,Joel R McConkey,

OBJECTIVE: To compare (1) mean low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride differences after switching from olanzapine to quetiapine, risperidone, or ziprasidone and (2) the mean lipid change between switch patterns. DESIGN: Retrospective, naturalistic, nonequivalent control group design. SETTING: United States between April 1, 2002, and September 30, 2002. PATIENTS: 1,826 U.S. Veterans Healthcare System enrollees with diagnoses of schizophrenia or schizoaffective disorders and receiving a second-generation antipsychotic (SGA) medication. INTERVENTIONS: Analysis of data from the Veterans Information Systems and Technology Architecture. MAIN OUTCOME MEASURES: Differences in LDL-C, HDL-C, and triglycerides and mean differences between switch patterns. Predictors were the type of switch (e.g., olanzapine to quetiapine) and switch patterns (e.g., olanzapine to quetiapine versus olanzapine to risperidone). Data were analyzed using Pearson's X2 and multivariate analysis of covariance with planned comparisons. RESULTS: After adjusting for age, gender, and race/ethnicity, LDL-C decreased significantly among patients switched from olanzapine to ziprasidone (-16.9 mg/dL, P <0.01) and olanzapine to quetiapine (-7.6 mg/dL, P = 0.04) and trended upward in patients switched from olanzapine to risperidone (+6.6 mg/dL, P = 0.12). Triglyceride levels decreased among those switched from olanzapine to ziprasidone (-62.9 mg/dL, P <0.01) and olanzapine to risperidone (-48.5 mg/dL, P <0.01) but not among veterans switched from olanzapine to quetiapine (+7.8 mg/dL, P = 0.54). HDL-C levels did not change significantly when veterans were switched from olanzapine to quetiapine, risperidone, or ziprasidone. CONCLUSION: Switching SGAs can increase or decrease cardiovascular risk depending on the clinician's follow-on SGA choice. LDL-C and triglyceride levels decreased significantly among veterans switched from olanzapine to ziprasidone. Switching to quetiapine was associated with a reduction in LDL-C, while switching to risperidone resulted in lower triglyceride levels. Clinicians should use these results when building a patient care plan that includes switching of SGAs.

Effect on lipid profiles of switching from olanzapine to another second-generation antipsychotic agent in veterans with schizophrenia. Publishing Authors By Initials

PM Garman,LD Ried,MA Bengtson,C Hsu,JR McConkey,

For similar persons: veterans research abstracts see: persons: veterans research

PUBMED ID PMID:

MEDLINE DATE: 2007 May-Jun

Effect on lipid profiles of switching from olanzapine to another second-generation antipsychotic agent in veterans with schizophrenia. Journal Published:

PUBLICATION TYPE: Research Support, U.S. Gov't,

Journal: Journal of the American Pharmacists Association :

VOLUME: 47

Page Numbers: 373-8

Journal Abbreviation:

ISSN: 1544-3450

DAY: 3

MONTH: 12

YEAR: 2007

Effect on lipid profiles of switching from olanzapine to another second-generation antipsychotic agent in veterans with schizophrenia. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 101176252

Effect on lipid profiles of switching from olanzapine to another second-generation antipsychotic agent in veterans with schizophrenia. Keywords Mesh Terms:

KEYWORDS: Veterans

MESH TERMS: blood

Chemical & Substance for Abstract: Effect on lipid profiles of switching from olanzapine to another second-generation antipsychotic agent in veterans with schizophrenia. Information

Substance Name: ziprasidone

Registry Number: 146939-27-7

Grant and Affiliation Information for Effect on lipid profiles of switching from olanzapine to another second-generation antipsychotic agent in veterans with schizophrenia.

AFFILIATION: College of Pharmacy, University of Florida, Gainesville, FL, USA.

Country: United States

AGENCY: United States NHLBI

GRANT: T35-HL07489

ACRONYM: HL

MEDLINETA: J Am Pharm Assoc (2003)

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