Metabolic effects of adjunctive aripiprazole in clozapine-treated patients with schizophrenia

Fan X, Borba CPC, Copeland P, Hayden D, Freudenreich O, Goff DC, Henderson DC. Metabolic effects of adjunctive aripiprazole in clozapine-treated patients with schizophrenia. Objective: This study examined the effects of adjunctive aripiprazole therapy on metabolism in clozapine-treated patients with schizophrenia. Method: In an 8-week randomized, double-blind, placebo-controlled study, subjects received either aripiprazole (15mg/day) or placebo. At baseline and week 8, metabolic parameters were assessed by the frequently sampled intravenous glucose tolerance test, nuclear magnetic resonance spectroscopy and whole-body dual-energy X-ray absorptiometry (DXA). Results: Thirty subjects completed the study (16 in the aripiprazole group and 14 in the placebo group). Glucose effectiveness measured by the frequently sampled intravenous glucose tolerance test improved significantly in the aripiprazole group (0.003 +/- 0.006 vs. 0.005 +/- 0.007/min, P=0.010). The aripiprazole group showed significant reductions in both plasma low-density lipoprotein (LDL) levels (15.1 +/- 19.8 vs. 4.4 +/- 22.5mg/dl, P=0.019) and LDL particle numbers (376 +/- 632 vs. 36 +/- 301nm, P=0.035). Further, there was a significant reduction in the lean mass (1125 +/- 1620 vs. 607 +/- 1578g, P=0.011) measured by whole-body DXA scan in the aripiprazole group. All values were expressed as mean +/- standard deviation, aripiprazole vs. placebo. Conclusion: Adjunctive therapy with aripiprazole may have some metabolic benefits in clozapine-treated patients with schizophrenia.