Metabolic changes in schizophrenic patients with olanzapine induced metabolic disorders after drug modification and recurrence influencing factors
Objective To study on metabolic changes in schizophrenic patients with olanzapine-induced metabolic disorders after medication modification and the influencing factors of recurrence.Methods A total of 217 patients with schizophrenia who had metabolic disorders after using olanzapine were selected at the Second People's Hospital of Lishui City from January 2022 to July 2023,and collected and compared changes in insulin resistance index(IRI),fasting blood glucose,total cholesterol,triglycerides,low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)levels at baseline and 3 months's medication in different drug treatment groups.The recurrence within 6 months after medication was recorded and the factors inducing the recurrence were analyzed.Results Compared with the baseline of the same group,the body mass index increased in the group switching to risperidone after changing medication for 3 months[(23.89±2.40)kg/m2 vs(24.67±1.73)kg/m2].After 3 months,the IRI decreased in the group switching to aripiprazole[(3.68±1.84)vs(4.70±2.28)].The total cholesterol and LDL-C levels decreased in the group switching to sulfamethoxide(4.24±1.08 mmol/L,2.7±0.8 mmol/L),while the baseline was(5.25±1.74)mmol/L and(3.3±1.2)mmol/L.The total cholesterol levels increased in the group switching to risperidone(5.33±1.33)mmol/L,while the baseline was(4.84±1.37)mmol/L.The differences above were statistically significant(P＜0.05).The multivariate Logistic regression model showed that the positive and negative syndrome scale(PANSS)score was an independent risk factor for disease recurrence(OR=1.1 10,P＜0.05),while the duration of stable condition before drug replacement,and the replacement with risperidone,budesonide,and sulfamethoxazole were protective factors(OR=0.826,0.339,0.477,0.490,all P＜0.05).Conclusion It is a complex task to change the antipsychotic treatment for patients with metabolic disorders after using olanzapine for schizophrenia,which requires to take multiple factors into consideration,especially the patients'baseline clinical condition and the risk of disease recurrence with the drug.
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