Clinical Management of Metabolic Problems in Patients With Schizophrenia
T. Scott Stroup, MD, MPH, Principal Investigator
This study, funded by the Foundation for the National Institutes of Health, will compare the effectiveness of antipsychotic medications for patients with schizophrenia or schizoaffective disorder for whom a medication change may be indicated because of an increased risk of cardiovascular disease.
Metabolic abnormalities associated with cardiovascular morbidity and premature mortality are more common in patients with schizophrenia than in matched controls. Although there is some evidence that patients with schizophrenia have intrinsic abnormalities in lipid and carbohydrate metabolism, some antipsychotics (i.e., clozapine, olanzapine, quetiapine, and risperidone) are associated with increased rates of metabolic abnormalities that predispose patients to cardiovascular disease.
This single-blind (rater) randomized controlled trial (N=300) will be conducted at 30 research sites in the NIMH Schizophrenia Trials Network. Patients with schizophrenia or schizoaffective disorder who are taking olanzapine, quetiapine, or risperidone and who have a body-mass index (BMI) greater than or equal to 27 and non-HDL cholesterol greater than or equal to 160 mg/dl will be eligible. Patients will be followed for up to 6 months.
The aims of the study are (1) to determine the relative effects of switching to aripiprazole, versus continued treatment with olanzapine, quetiapine, or risperidone, on metabolic parameters associated with cardiovascular disease; and (2) to determine the effects of switching to aripiprazole versus continued treatment with olanzapine, quetiapine, or risperidone on the clinical stability of schizophrenic illness.
