Impact of antipsychotic treatment on nonfasting triglycerides in the CATIE Schizophrenia Trial phase 1

Jonathan M. Meyer, Vicki G. Davis, Joseph Patrick McEvoy, Donald C. Goff, Henry A. Nasrallah, Sonia M. Davis, Gail L. Daumit, John Hsiao, Marvin S. Swartz, T. Scott Stroup, Jeffrey A. Lieberman

Research output: Contribution to journalArticlepeer-review

61 Scopus citations

Abstract

Background: Recent literature documents a stronger association between nonfasting triglycerides (TG) and cardiovascular risk compared to fasting TG. Given concerns over antipsychotic effects on serum TG, this analysis explored changes in nonfasting TG in phase 1 of the CATIE Schizophrenia Trial. Methods: Change in nonfasting TG, adjusted for baseline value, was compared between antipsychotic treatment groups using subjects with nonfasting laboratory assessments at baseline and 3 months. Results: Among the 246 subjects there were significant treatment differences in 3-month change from baseline (p = 0.009). The greatest increases in median and adjusted mean nonfasting TG levels were seen among those randomized to quetiapine (mean + 54.7 mg/dl, median + 26 mg/dl) and olanzapine (mean + 23.4 mg/dl, median + 26.5 mg/dl), while ziprasidone was neutral (mean + 0.0 mg/dl, median + 8 mg/dl), and decreases were seen with risperidone (mean - 18.4 mg/dl, median - 6.5 mg/dl) and perphenazine (mean - 1.3 mg/dl, median - 22 mg/dl). Pairwise comparisons indicated a significant between-group difference for perphenazine vs. olanzapine (p = 0.002) and a trend for perphenazine vs. quetiapine (p = 0.006). Conclusions: This analysis provides further evidence for differential antipsychotic metabolic liabilities, and confirms signals for the effects of olanzapine and quetiapine on serum TG seen in earlier CATIE analyses. Future consensus recommendations will clarify the role of nonfasting TG monitoring in routine clinical practice.

Original languageEnglish (US)
Pages (from-to)104-109
Number of pages6
JournalSchizophrenia Research
Volume103
Issue number1-3
DOIs
StatePublished - Aug 2008

Keywords

  • Antipsychotic
  • Cardiovascular risk
  • Lipids
  • Nonfasting
  • Schizophrenia
  • Triglycerides

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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