Clinical Guidance: Metabolic Effects of Switching to Aripiprazole in Schizophrenia
Patients with a body mass index of 27 or higher and a level of non-HDL cholesterol of 130 mg/dl or higher who were taking a stable dosage of olanzapine, quetiapine, or risperidone were randomly assigned to stay on the current medication or switch to aripiprazole for 24 weeks by Stroup et al. (p. 947). All participants were enrolled in a diet and exercise program. Non-HDL cholesterol decreased more for patients switched to aripiprazole (figure). Switching to aripiprazole was associated with larger reductions in weight and a net reduction of serum triglycerides. There was no difference in the rate of treatment failure, but nearly twice as many patients discontinued the new aripiprazole regimen before 24 weeks. In an editorial (p. 882), Weiden calls for similar research on switching medications to improve efficacy.
Non-HDL cholesterol, weight, and triglycerides declined after a switch to aripiprazole (Stroup et al., p. 947)