Effect of Olanzapine on Metabolic Syndrome- A One Year Follow-up Study

Introduction: Patients with schizophrenia have increased risk of cardiovascular mortality and this is partly attributed to antipsychotics. Olanzapine, one of first line antipsychotic for the management of schizophrenia is associated with Metabolic syndrome (MetS). There is paucity of follow-up studies on course of metabolic parameters with Olanzapine. Aim: To understand the effect of Olanzapine on weight, Fasting blood glucose, Triglycerides (TG), High Density Lipoprotein (HDL), and Waist Circumference (WC) in patients with schizophrenia. Materials and Methods: This was a prospective observational study where metabolic parameters of patients with schizophrenia were assessed prior to initiation of olanzapine and after one year. Physical health [Blood Pressure (BP), WC, Weight] and laboratory indices (fasting blood sugar, HDL and TG) were evaluated and compared. The association between qualitative variables were assessed using chi-square test and differences in metabolic parameters before and after olanzapine was assessed using paired t-test. Results: The prevalence of MetS before initiation of olanzapine was 15.4% which increased to 56.9% in one year as per Adult Treatment Protocol of the National Cholesterol Education Program (NCEP ATP III) criteria. There was statistically significant difference in weight, fasting blood glucose, TG, HDL and WC at the end of one year when compared to baseline (p-value <0.05). Conclusion: Olanzapine has high propensity to derange metabolic parameters in patients with schizophrenia. Close monitoring and lifestyle modification is advised to prevent adverse metabolic effects of olanzapine.