Risk of lipid abnormality with haloperidol, olanzapine, quetiapine, and risperidone in a Veterans Affairs population.
Risk of lipid abnormality with haloperidol, olanzapine, quetiapine, and risperidone in a Veterans Affairs population.
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退伍军人事务部人群中使用氟哌啶醇、奥氮平、喹硫平和利培酮导致血脂异常的风险。
DOI：
10.1097/yic.0b013e32832d6c18
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发表时间：
2009
影响因子：
2.6
通讯作者：
Dunlop,BoadieW
中科院分区：
文献类型：
--
作者：
Duncan,EricaJ;Woolson,SandraL;Hamer,RobertM;Dunlop,BoadieW
第二代抗精神病药物引起血脂升高的速度比旧的典型抗精神病药物更快。这种风险可能不等同于第二代抗精神病药物。我们对6331名服用抗精神病药物的患者进行了一项计算机化、回顾性、非随机的病例对照分析。对于每个患者，对四种抗精神病药物[氟哌啶醇(HALD)、奥氮平(OLANZ)、奎硫平(QUT)或利培酮(RISP)]连续至少60天的第一次处方进行总胆固醇、低密度脂蛋白、高密度脂蛋白(HDL)和甘油三酯(TGL)的分析。治疗期间平均高密度脂蛋白低于RISP0.03或CITE(P=0.001)。OLANZ(P=0.0007)和QUET(P=0.006)组的TGL均高于RISP组。在二分法分析中，受试者在服药期间出现异常胆固醇(P=0.0003)、低密度脂蛋白(P=0.001)或甘油三酯(P=0.0001)的优势比依次为：OLANZ>；QUET>；RISP>；HALD。对于高密度脂蛋白，结果不那么稳健，但参与者的百分比顺序如下：OLANZ>；RISP=HALD=QUIT。在未用药基线期间没有血脂异常的患者的紧急治疗分析中，使用OLANZ的患者发生新的高密度脂蛋白异常的风险比RISP更大(P<；0.05)。总而言之，RISP或HALD的治疗与OLANZ或QUET相比具有更有利的血脂谱。
Second-generation antipsychotics can cause lipid elevations at a greater rate than older typical antipsychotics. This risk may not be equivalent amongst the second-generation antipsychotics. We conducted a computerized, retrospective, nonrandomized, case–control analysis of 6331 patients receiving antipsychotics. For each patient, the first prescription for at least 60 continuous days for four antipsychotics [haloperidol (HALD), olanzapine (OLANZ), quetiapine (QUET), or risperidone (RISP)] was analyzed for total cholesterol, low-density lipoprotein, high-density lipoprotein (HDL), and triglycerides (TGL). Mean HDL was lower during OLANZ treatment than with RISP (P= 0.03) or QUET (P= 0.001). TGL were higher during OLANZ (P= 0.0007) or QUET treatment (P= 0.006) than RISP. In dichotomous analyses, odds ratios on the percentage of participants having abnormal cholesterol (P= 0.0003), low-density lipoprotein (P= 0.001), or TGL (P= 0.0001) during medication were in the order: OLANZ> QUET> RISP> HALD. For HDL, the results were less robust but the percentage of participants were in the order: OLANZ> RISP= HALD= QUET. In treatment-emergent analyses of patients without lipid abnormalities during an unmedicated baseline period, there was a greater risk of developing new HDL abnormality with OLANZ than RISP (P< 0.05). In conclusion, treatment with RISP or HALD was associated with a more favorable lipid profile than with OLANZ or QUET.