10007481 J Clin Psychiatry / Document Archive

Psychiatrist.com Home    Keyword Search

Close [X]

Search Our Sites

Enter search terms below (keywords, titles, authors, or subjects). Then select a category to search and press the Search button. All words are assumed to be required. To search for an exact phrase, put it in quotes. To exclude a term, precede it with a minus sign (-).

Keyword search:

Choose a category:

Choosing the appropriate category will greatly improve your chances of finding the best match.

All files at our sites: J Clin Psychiatry, Primary Care Companion, CME Institute, and MedFair

Search materials from our journals:

Abstracts from The Journal of Clinical Psychiatry, 1996–present, both regular issues and supplements

PDFs of the full text of The Journal of Clinical Psychiatry, 1996–present, both regular issues and supplements (Net Society Platinum [paid subscribers])

PDFs of the full text of The Primary Care Companion to The Journal of Clinical Psychiatry, 1999–present

Search CME offerings:

CME Institute, including CME from journals , supplements, and Web activities for instant CME credit (Net Society Gold [registered users]); also includes information about our CME program

CME activities from regular issues of The Journal of Clinical Psychiatry (Net Society Gold [registered users])

CME Supplements from The Journal of Clinical Psychiatry (Net Society Gold [registered users])

 

The article you requested is

A 12-Month Randomized, Open-Label Study of the Metabolic Effects of Olanzapine and Risperidone in Psychotic Patients: Influence of Valproic Acid Augmentation

J Clin Psychiatry 2011;72(12):1602-1610
10.4088/JCP.10m05997
Copyright 2011 Physicians Postgraduate Press, Inc.

To view this item, select one of the options below.

  1. NONSUBSCRIBERS
    1. Purchase this PDF for $40
      If you are not a paid subscriber, you may purchase the PDF.
      (You'll need the free Adobe Acrobat Reader.)
    2. Subscribe
      Receive immediate full-text access to JCP. You can subscribe to JCP print + online for $166 individual.
      JCP's 75th AnniversaryCelebrate!
      Celebrate JCP's 75th Anniversary with a special online-only subscription price of $75.
  2. PAID SUBSCRIBERS
    1. Activate
      If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
    2. Sign in
      As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
  1. Did you forget your password?

Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send an email

| 54.82.22.63

Objective: Longitudinal data comparing the metabolic effects of olanzapine and risperidone with or without valproic acid supplementation in schizophrenic and bipolar patients are lacking.

Method: This study compares the metabolic effects of olanzapine and risperidone in a prospective, randomized, open-label trial in 160 patients with DSM-IV-TR schizophrenia, schizoaffective disorder, or bipolar disorder after 1, 3, 6, and 12 months’ treatment. The study was conducted between 2000 and 2006. The primary analysis compared all patients randomized to olanzapine or risperidone; the primary outcome measure was changes in triglycerides (TG), and TG/high density lipoprotein cholesterol (HDL-C) ratio, a risk factor for ischemic cardiovascular disease. Secondary analyses included the effect of concomitant valproic acid.

Results: Significantly greater increases in weight (F4,434 = 4.7), body mass index (BMI) (F4,424 = 5.1), glycosylated hemoglobin (HgbA1c) (F4,427 = 4.3), total cholesterol (F4,429 = 4.4), TG (F4,426 = 5.9), and TG/HDL-C ratio (F4,426 = 4.3) (P < .005 for all drug × time interaction effects) were observed at all but the initial time points in the olanzapine- compared to the risperidone patients. Olanzapine/+valproic acid produced significantly greater increases in HgbA1c, BMI, weight, TG, and TG/HDL-C than olanzapine/–valproic acid at 3 and 6 months, while risperidone/+valproic acid produced significantly smaller increases in HgbA1c, BMI, and weight at 1, 3, and 6 months than risperidone/–valproic acid. The olanzapine/+valproic acid group had significantly greater BMI, and weight at 1, 3, and 6 months, and greater HgbA1c at 3 and 6 months, compared with the risperidone/+valproic acid group. There were too few patients treated with mood stabilizers other than valproic acid to analyze effects of any other mood stabilizer separately. Metabolic effects did not differ significantly by diagnostic category (schizophrenia/schizoaffective disorder vs bipolar disorder).

Conclusion: Further study of the metabolic effects of adjunctive valproic acid is indicated, as valproic acid may produce markedly different metabolic effects when combined with various antipsychotic drugs.

Trial Registration: clinicaltrials.gov Identifier: NCT00179062

J Clin Psychiatry

Submitted: January 22, 2010; accepted August 3, 2010.

Online ahead of print: July 12, 2011 (doi:10.4088/JCP.10m05997).

Corresponding author: Herbert Y. Meltzer, MD, 1601 23rd Ave South, Ste 3035, Nashville, TN 37212-8645 (Herbert.meltzer@vanderbilt.edu).