An assessment of the independent effects of olanzapine and risperidone exposure on the risk of hyperlipidemia in schizophrenic patients

Murray B. Stein, Philip R Goldin, Jitender Sareen, Lisa T. Eyler Zorrilla, Gregory G. Brown

Research output: Contribution to journalArticle

215 Citations (Scopus)

Abstract

Background: The newer antipsychotic agents exhibit a superior safety profile compared with conventional antipsychotic agents in terms of extrapyramidal symptoms. Previous studies have suggested an association between olanzapine treatment and hyperlipidemia. We evaluated this association using a large health care database. Methods: The study was derived from the England and Wales-based General Practice Research Database, composed of 3.5 million subjects followed up between June 1, 1987, and September 24, 2000. A total of 18 309 individuals diagnosed as having schizophrenia were identified. A 6:1 matched nested case-control design was used. Conditional logistic regression was used to derive adjusted odds ratios (ORs), controlling for sex, age, and other medications and disease conditions influencing lipid levels. Antipsychotic drug exposure was defined as the receipt of at least 1 prescription for an antipsychotic medication within the 3 months before the date of diagnosis of hyperlipidemia. Results: There were 1268 incident cases of hyperlipidemia in the cohort, matched to 7598 control subjects. Olanzapine use was associated with nearly a 5-fold increase in the odds of developing hyperlipidemia compared with no antipsychotic exposure (OR, 4.65; 95% confidence interval [CI], 2.44-8.85) (P<.001) and more than a 3-fold increase compared with those receiving conventional agents (OR, 3.36; 95% CI, 1.77-6.39) (P<.001). Risperidone was not associated with increased odds of hyperlipidemia compared with no antipsychotic exposure (OR, 1.12; 95% CI, 0.60-2.11) (P=.72) or conventional antipsychotic exposure (OR, 0.81; 95% CI, 0.44-1.52) (P=.52). Conclusions: We observed a strong association between olanzapine exposure and hyperlipidemia in schizophrenic patients. The possible metabolic consequences of olanzapine use should be given serious consideration by treating physicians.

Original languageEnglish (US)
Pages (from-to)1021-1026
Number of pages6
JournalArchives of General Psychiatry
Volume59
Issue number11
DOIs
StatePublished - Nov 1 2002

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olanzapine
Risperidone
Hyperlipidemias
Antipsychotic Agents
Odds Ratio
Confidence Intervals
Databases
Wales
General Practice
England
Prescriptions
Schizophrenia
Logistic Models

ASJC Scopus subject areas

  • Psychiatry and Mental health

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An assessment of the independent effects of olanzapine and risperidone exposure on the risk of hyperlipidemia in schizophrenic patients. / Stein, Murray B.; Goldin, Philip R; Sareen, Jitender; Eyler Zorrilla, Lisa T.; Brown, Gregory G.

In: Archives of General Psychiatry, Vol. 59, No. 11, 01.11.2002, p. 1021-1026.

Research output: Contribution to journalArticle

Stein, Murray B. ; Goldin, Philip R ; Sareen, Jitender ; Eyler Zorrilla, Lisa T. ; Brown, Gregory G. / An assessment of the independent effects of olanzapine and risperidone exposure on the risk of hyperlipidemia in schizophrenic patients. In: Archives of General Psychiatry. 2002 ; Vol. 59, No. 11. pp. 1021-1026.
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abstract = "Background: The newer antipsychotic agents exhibit a superior safety profile compared with conventional antipsychotic agents in terms of extrapyramidal symptoms. Previous studies have suggested an association between olanzapine treatment and hyperlipidemia. We evaluated this association using a large health care database. Methods: The study was derived from the England and Wales-based General Practice Research Database, composed of 3.5 million subjects followed up between June 1, 1987, and September 24, 2000. A total of 18 309 individuals diagnosed as having schizophrenia were identified. A 6:1 matched nested case-control design was used. Conditional logistic regression was used to derive adjusted odds ratios (ORs), controlling for sex, age, and other medications and disease conditions influencing lipid levels. Antipsychotic drug exposure was defined as the receipt of at least 1 prescription for an antipsychotic medication within the 3 months before the date of diagnosis of hyperlipidemia. Results: There were 1268 incident cases of hyperlipidemia in the cohort, matched to 7598 control subjects. Olanzapine use was associated with nearly a 5-fold increase in the odds of developing hyperlipidemia compared with no antipsychotic exposure (OR, 4.65; 95{\%} confidence interval [CI], 2.44-8.85) (P<.001) and more than a 3-fold increase compared with those receiving conventional agents (OR, 3.36; 95{\%} CI, 1.77-6.39) (P<.001). Risperidone was not associated with increased odds of hyperlipidemia compared with no antipsychotic exposure (OR, 1.12; 95{\%} CI, 0.60-2.11) (P=.72) or conventional antipsychotic exposure (OR, 0.81; 95{\%} CI, 0.44-1.52) (P=.52). Conclusions: We observed a strong association between olanzapine exposure and hyperlipidemia in schizophrenic patients. The possible metabolic consequences of olanzapine use should be given serious consideration by treating physicians.",
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