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Article: Changes in serum lipids, independent of weight, are associated with changes in symptoms during long-term clozapine treatment

TitleChanges in serum lipids, independent of weight, are associated with changes in symptoms during long-term clozapine treatment
Authors
Issue Date2007
PublisherCanadian Medical Association. The Journal's web site is located at http://www.cma.ca/index.cfm/ci_id/12267/la_id/1.htm
Citation
Journal Of Psychiatry And Neuroscience, 2007, v. 32 n. 5, p. 331-338 How to Cite?
AbstractObjective: Investigators have reported that weight gain attributed to clozapine is associated with its clinical response. However, weight gain is a nonspecific physiological variable that, in itself, does not explain the mechanism underlying this relation. Alternatively, other biological variables that are often associated with weight gain, such as serum lipids, may assist in explaining this observation. The primary objective of this study was to determine whether an increase in serum lipids is associated with improvement in schizophrenia symptoms during steady state treatment with clozapine. Methods: The data for this study represent a subset of data from a randomized, double-blinded trial that evaluated subjects with schizophrenia who demonstrated a poor treatment response to clozapine. While continuing their clozapine therapy, subjects were randomly assigned to receive either risperidone 3 mg daily or placebo for 8 weeks. This course of treatment was followed by an optional (open-label) 18 weeks of augmentation with risperidone. In the present study, we included all subjects from the previously reported trial who had fasting lipid analyses and Positive and Negative Syndrome Scale (PANSS) scores from days 7 and 63 (n = 55). For the primary analyses, we used multiple regression to examine the association between serum lipid concentrations and PANSS scores, after controlling for weight. Results: The analyses showed that the change in serum lipid concentration predicted change in symptoms over that of change in weight. Specifically, an increase in serum triglyceride concentration was associated with a decrease in the total PANSS score (p = 0.037). In addition, an increase in either serum total cholesterol concentration (p = 0.007), serum triglyceride concentration (p = 0.017) or their combined effect (p = 0.010) was associated with a decrease in PANSS negative subscale scores. Conclusion: Elevation of serum lipids is associated with an improvement in schizophrenia symptoms in subjects treated with clozapine. Although the mechanism is unclear, serum lipids may play a role in influencing clozapine's therapeutic activity. © 2007 Canadian Medical Association.
Persistent Identifierhttp://hdl.handle.net/10722/171944
ISSN
2015 Impact Factor: 5.57
2015 SCImago Journal Rankings: 2.675
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorProcyshyn, RMen_US
dc.contributor.authorWasan, KMen_US
dc.contributor.authorThornton, AEen_US
dc.contributor.authorBarr, AMen_US
dc.contributor.authorChen, EYHen_US
dc.contributor.authorPomarolClotet, Een_US
dc.contributor.authorStip, Een_US
dc.contributor.authorWilliams, Ren_US
dc.contributor.authorMacewan, GWen_US
dc.contributor.authorBirmingham, CLen_US
dc.contributor.authorHoner, WGen_US
dc.date.accessioned2012-10-30T06:18:41Z-
dc.date.available2012-10-30T06:18:41Z-
dc.date.issued2007en_US
dc.identifier.citationJournal Of Psychiatry And Neuroscience, 2007, v. 32 n. 5, p. 331-338en_US
dc.identifier.issn1180-4882en_US
dc.identifier.urihttp://hdl.handle.net/10722/171944-
dc.description.abstractObjective: Investigators have reported that weight gain attributed to clozapine is associated with its clinical response. However, weight gain is a nonspecific physiological variable that, in itself, does not explain the mechanism underlying this relation. Alternatively, other biological variables that are often associated with weight gain, such as serum lipids, may assist in explaining this observation. The primary objective of this study was to determine whether an increase in serum lipids is associated with improvement in schizophrenia symptoms during steady state treatment with clozapine. Methods: The data for this study represent a subset of data from a randomized, double-blinded trial that evaluated subjects with schizophrenia who demonstrated a poor treatment response to clozapine. While continuing their clozapine therapy, subjects were randomly assigned to receive either risperidone 3 mg daily or placebo for 8 weeks. This course of treatment was followed by an optional (open-label) 18 weeks of augmentation with risperidone. In the present study, we included all subjects from the previously reported trial who had fasting lipid analyses and Positive and Negative Syndrome Scale (PANSS) scores from days 7 and 63 (n = 55). For the primary analyses, we used multiple regression to examine the association between serum lipid concentrations and PANSS scores, after controlling for weight. Results: The analyses showed that the change in serum lipid concentration predicted change in symptoms over that of change in weight. Specifically, an increase in serum triglyceride concentration was associated with a decrease in the total PANSS score (p = 0.037). In addition, an increase in either serum total cholesterol concentration (p = 0.007), serum triglyceride concentration (p = 0.017) or their combined effect (p = 0.010) was associated with a decrease in PANSS negative subscale scores. Conclusion: Elevation of serum lipids is associated with an improvement in schizophrenia symptoms in subjects treated with clozapine. Although the mechanism is unclear, serum lipids may play a role in influencing clozapine's therapeutic activity. © 2007 Canadian Medical Association.en_US
dc.languageengen_US
dc.publisherCanadian Medical Association. The Journal's web site is located at http://www.cma.ca/index.cfm/ci_id/12267/la_id/1.htmen_US
dc.relation.ispartofJournal of Psychiatry and Neuroscienceen_US
dc.subject.meshAntipsychotic Agents - Adverse Effects - Therapeutic Useen_US
dc.subject.meshBody Weight - Physiologyen_US
dc.subject.meshClozapine - Adverse Effects - Therapeutic Useen_US
dc.subject.meshData Interpretation, Statisticalen_US
dc.subject.meshDouble-Blind Methoden_US
dc.subject.meshHumansen_US
dc.subject.meshLipids - Blooden_US
dc.subject.meshRisperidone - Therapeutic Useen_US
dc.subject.meshSchizophrenia - Blood - Drug Therapyen_US
dc.subject.meshSchizophrenic Psychologyen_US
dc.subject.meshTreatment Outcomeen_US
dc.subject.meshTriglycerides - Blooden_US
dc.titleChanges in serum lipids, independent of weight, are associated with changes in symptoms during long-term clozapine treatmenten_US
dc.typeArticleen_US
dc.identifier.emailChen, EYH:eyhchen@hku.hken_US
dc.identifier.authorityChen, EYH=rp00392en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid17823649-
dc.identifier.scopuseid_2-s2.0-34848827473en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-34848827473&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume32en_US
dc.identifier.issue5en_US
dc.identifier.spage331en_US
dc.identifier.epage338en_US
dc.identifier.isiWOS:000249157100004-
dc.publisher.placeCanadaen_US
dc.identifier.scopusauthoridProcyshyn, RM=7003797939en_US
dc.identifier.scopusauthoridWasan, KM=7006741955en_US
dc.identifier.scopusauthoridThornton, AE=7101607212en_US
dc.identifier.scopusauthoridBarr, AM=35474239200en_US
dc.identifier.scopusauthoridChen, EYH=7402315729en_US
dc.identifier.scopusauthoridPomarolClotet, E=8873538700en_US
dc.identifier.scopusauthoridStip, E=7006409461en_US
dc.identifier.scopusauthoridWilliams, R=12788026400en_US
dc.identifier.scopusauthoridMacEwan, GW=6604052646en_US
dc.identifier.scopusauthoridBirmingham, CL=7005293592en_US
dc.identifier.scopusauthoridHoner, WG=7004460814en_US

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