Diabetes, heart risk lower with newer antipsychotic

In a study of schizophrenic patients, those treated with the newer antipsychotic drug Abilify had more favorable changes in metabolic parameters such as blood sugar, lipids and body weight, compared to those receiving older "standard of care" agents.

This translates into a reduced risk of diabetes and heart disease in Abilify-treated patients, researchers report. Abilify, which is also called aripiprazole, is a second-generation "atypical" antipsychotic agent.

"Patients with schizophrenia are at increased risk of developing diabetes mellitus and cardiovascular disease," Dr. Hong J. Kan, of Bristol-Myers Squibb Co., Wallingford, Connecticut, and colleagues note in the Journal of Clinical Psychiatry. "Furthermore, some atypical antipsychotics are associated with metabolic disturbances, which augment the risk for these comorbid conditions."

Results of the Schizophrenia Trial of Aripiprazole, or STAR, study, demonstrated that aripiprazole was comparable or superior to "standard of care" drugs (quetiapine, olanzapine, or risperidone) depending on the outcome measure.

In a post hoc analysis of the metabolic data collected in the study, Kan and colleagues observed more favorable changes in blood fats (lipids), blood sugar, and body weight in patients treated with aripiprazole compared with those treated with the other agents.

One model predicted 23.4 fewer instances of new cases of diabetes with aripiprazole versus the older drugs. Another "hypothetical" model predicted 3.9 fewer heart disease-related events with aripiprazole versus the older drugs.

"Treatment with aripiprazole provides similar efficacy relative to other antipsychotic agents, and, in addition, its favorable metabolic profile offers potential health benefits," Kan and colleagues conclude.

SOURCE: Journal of Clinical Psychiatry, May 2008.