The use of certain atypical
antipsychotics has been associated with metabolic disturbances. We have assessed the evolution of
body weight and glycaemia during a 6-month randomized comparative trial of
amisulpride and
olanzapine. Three hundred and seventy-seven adult patients with
schizophrenia were randomized to either
amisulpride (200-800 mg/day) or
olanzapine (5-20 mg/day) for 6 months.
Body weight and fasting
blood glucose were measured. Both treatments showed comparable
antipsychotic activity.
Weight gain over the study was significantly greater (P=0.0004) in the
olanzapine group (3.9+/-5.3 kg) than in the
amisulpride group (1.6+/-4.9 kg). Mean fasting
blood glucose increased in the
olanzapine group by 4.42 mg/dl to a mean maximum value (118+/-38 mg/dl). In the
amisulpride group, mean
glucose levels fell by 2.82 mg/dl. The difference between groups was significant at 2 (P=0.0066) and 6 months (P=0.017). One
olanzapine-treated patient was diagnosed with diabetes. Metabolic changes in the
amisulpride group were restricted to patients with high body mass index at inclusion. At doses that provide comparable control of
psychosis, treatment with
olanzapine was associated with greater increase in weight and
blood glucose compared with
amisulpride. This should be taken into account in assessing risk-benefit of treatment options in
schizophrenia.