An Assessment of the Independent Effects of Olanzapine and Risperidone Exposure on the Risk of Hyperlipidemia in Schizophrenic Patients

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Abstract
IN RECENT decades, several new antipsychotic agents exhibiting improved mechanisms of action compared with conventional antipsychotic agents have been widely adopted in the clinical treatment of schizophrenia. The clearest advantage of the newer antipsychotic agents is the reduction of extrapyramidal adverse effects.1 However, the new-generation antipsychotic agents are associated with a different spectrum of adverse effects, including weight gain,2 alterations in glucose metabolism,3-5 and elevations of blood cholesterol and lipid levels.2,6 Most of these observations are based primarily on case reports7-9 and1 small comparative study.6 If these associations were confirmed in larger studies, one might conclude that the nutritional and metabolic effects of the new-generation antipsychotic agents are as serious as the extrapyramidal effects seen with conventional antipsychotic agents.10 For example, lipid elevations have been unequivocally associated with an increased risk for cardiovascular events, such as myocardial infarction and stroke, in general populations.11-14 More recently, the US Adult Treatment Panel III guidelines15 recommend aggressive modification of lipid levels to reduce cardiovascular risk.