Aripiprazole and Risperidone Present Comparable Long-Term Metabolic Profiles: Data From a Pragmatic Randomized Controlled Trial in Drug-Naïve First-Episode Psychosis

Author:

Vázquez-Bourgon Javier123ORCID,Ortiz-García de la Foz Víctor1,Gómez-Revuelta Marcos13ORCID,Mayoral-van Son Jacqueline24ORCID,Juncal-Ruiz María35,Garrido-Torres Nathalia24,Crespo-Facorro Benedicto24ORCID

Affiliation:

1. Department of Psychiatry, University Hospital Marqués de Valdecilla - Instituto de Investigación Marqués de Valdecilla (IDIVAL) , Santander , Spain

2. Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM) , Sevilla , Spain

3. Department of Medicine and Psychiatry, School of Medicine, Universidad de Cantabria , Santander , Spain

4. Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocío-IBiS , Sevilla , Spain

5. Department of Psychiatry, Sierrallana Hospital - Instituto de Investigación Marqués de Valdecilla (IDIVAL) , Torrelavega , Spain

Abstract

Abstract Objective Aripiprazole and risperidone are 2 of the most used second-generation antipsychotics (SGAs) worldwide. Previous evidence shows a similar effect of these SGAs on weight and metabolic changes in the short term. However, a longer period is necessary for a better assessment of the SGA´s metabolic profile. We aimed to compare the long-term (1-year) metabolic profile of these 2 antipsychotics on a sample of drug-naïve first episode-psychosis (FEP) patients. Methods A total 188 drug-naïve patients, suffering from a first episode of non-affective psychosis (FEP), were randomly assigned to treatment with either aripiprazole or risperidone. Weight and glycemic/lipid parameters were recorded at baseline and after 1-year follow-up. Results We observed significant weight increments in both groups (9.2 kg for aripiprazole and 10.5 kg for risperidone) after 1 year of treatment. Despite this, weight and body mass index changes did not significantly differ between treatment groups (P > .05). Similarly, both treatment groups presented similar metabolic clinical impact with a comparable increase in the proportion of participants meeting criteria for metabolic disorders such as obesity or hypercholesterolemia, but not for metabolic syndrome (Δ9.2% vs Δ4.3%) or hypertriglyceridemia (Δ21.9% vs Δ8.0%), where aripiprazole showed worse outcomes than risperidone. Conclusion This study shows that aripiprazole and risperidone share a similar long-term metabolic profile. After 1 year of antipsychotic treatment, drug-naïve FEP patients in both treatment groups presented a significant increase in weight and metabolic changes, leading to a greater prevalence of metabolic disorders.

Funder

Instituto de Investigación Sanitaria Valdecilla

Instituto de Salud Carlos III

Publisher

Oxford University Press (OUP)

Subject

Pharmacology (medical),Psychiatry and Mental health,Pharmacology

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