Effects of three atypical antipsychotics on blood glucose and lipids,prolactin and thyroid hormone in firste-pisode schizophrenic patients

Objective To investigate the effects of three atypical antipsychotics on blood glucose and lipids,prolactin and thyroid hormone in patients with first-episode schizophrenia. Methods Altogether 85 patients with first-episode schizophrenia were randomly assigned into olanzapine group (n=29),paliperidone group (n=28) and aripiprazole group (n=28) for 8 weeks.The serum levels of fasting blood glucose (FBG),triglyceride (TG),total cholesterol (TC),high density lipoprotein (HDL),low density lipoprotein (LDL),prolactin (PRL),thyroid stimulating hormone (TSH),triiodothyronine (T3),thyroxine (T4),free triiodothyronine (FT3) and free thyroxine (FT4) were measured before and after treatment. Results ①The levels of FBG,TG,and TC in olanzapine group after treatment were significantly higher than those before treatment (P<0.05),HDL was significantly lower than that before treatment (P<0.05);TG in paliperidone group was significantly higher than that before treatment (P<0.05),and no statistical difference was found in blood glucose and lipids compared with those before treatment of aripiprazole group (P>0.05).②The serum PRL of olanzapine group and paliperidone group was significantly higher than those before treatment (P<0.05) with paliperidone group which was found to be increased more significantly (P<0.05),and the PRL of aripiprazole group was decreased but without significant difference (P>0.05).③The levels of T3 and T4 in olanzapine group were significantly lower than those before treatment (P<0.05),and the levels of T4 and FT4 in paliperidone group and aripiprazole group were significantly lower than those before treatment (P<0.05).④PANSS scores of three groups were significantly lower than those before treatment (P<0.05). Conclusion Olanzapine,paliperidone and aripiprazole have significant therapeutic effect on first-episode schizophrenia.Olanzapine affects blood glucose and lipids significantly,paliperidone affects triglycerides significantly,and effects of aripiprazole are not obvious on blood glucose and lipids.All three can affect prolactin and thyroid hormone,and paliperidone is found to significantly increase prolactin.