Effects of Switching From Olanzapine, Quetiapine, and Risperidone to Aripiprazole on 10-Year Coronary Heart Disease Risk and Metabolic Syndrome Status: Results From a Randomized Controlled Trial
Open accessAbstract
Purpose This study examined the clinical significance of switching from olanzapine, quetiapine, or risperidone to aripiprazole by examining changes in predicted risk of cardiovascular disease (CVD) according to the Framingham Risk Score (FRS) and metabolic syndrome status. FRS estimates 10-year risk of "hard" coronary heart disease (CHD) outcomes (myocardial infarction and coronary death) while metabolic syndrome is associated with increased risk of CVD, stroke, and diabetes mellitus. Method Changes in FRS and metabolic syndrome status were compared between patients with BMI ≥ 27 and non-HDL-C ≥ 130 mg/dL randomly assigned to stay on stable current treatment (olanzapine, quetiapine, or risperidone) or switch to treatment with aripiprazole with 24 weeks of follow-up. All study participants were enrolled in a behavioral program that promoted healthy diet and exercise. Results The pre-specified analyses included 89 switchers and 98 stayers who had post-baseline measurements needed to assess changes. Least squares mean estimates of 10-year CHD risk decreased more for the switch (from 7.0% to 5.2%) than the stay group (from 7.4% to 6.4%) (p = 0.0429). The odds ratio for having metabolic syndrome (stay vs. switch) at the last observation was 1.748 (95% CI 0.919, 3.324, p = 0.0885). Conclusion Switching from olanzapine, quetiapine, or risperidone to aripiprazole was associated with larger reductions in predicted 10-year risk of CHD than the behavioral program alone. The advantage of switching on metabolic syndrome was not statistically significant. The benefits of switching must be balanced against its risks, which in this study included more discontinuations of the study treatment but no significant increase in symptoms or hospitalizations.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Many of the studies reporting on the effect of switching to partial agonists were uncontrolled with metabolic disturbances being the primary outcome, which increases the risk that participants engaged in parallel weight reducing behaviors, which could inflate the effect.
“Many of the studies reporting on the effect of switching to partial agonists were uncontrolled with metabolic disturbances being the primary outcome, which increases the risk that the participants engaged in parallel weight reducing behaviors, seen as a manualized co-treatment in one study (77), which could inflate the effect.”
From Reversibility of Antipsychotic-Induced Weight Gain: A Systematic Review and Meta-Analysis (2021) · cites this paper as [77]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Mortality and causes of death in schizophrenia in Stockholm County, Sweden
Ösby, U., Correia, N., Brandt, L., Ekbom, A., & Sparén, P. (2000) · Schizophrenia Research · doi:10.1016/s0920-9964(99)00191-7 · Cited by 679 · see citing works
Daumit, G. L., Goff, D. C., Meyer, J. M., Davis, V. G., Nasrallah, H. A., McEvoy, J. P., Rosenheck, R., Davis, S. M., Hsiao, J. K., Stroup, T. S., et al. (2008) · Schizophrenia Research · doi:10.1016/j.schres.2008.07.006 · Cited by 223 · see citing works
Self-citationThe metabolic syndrome: time to get off the merry-go-round?: Review: The metabolic syndrome
Reaven, G. M. (2011) · Journal of Internal Medicine · doi:10.1111/j.1365-2796.2010.02325.x · Cited by 214 · see citing works
Flagged first, then by citations
Research works printed but not linked: 21
- Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report Circulation 106 25 3143 3421 12485966
- Consensus development conference on antipsychotic drugs and obesity and diabetes J Clin Psychiatry 65 2 267 272 15003083
- Alberti KG Zimmet P 2005 The metabolic syndrome--a new worldwide definition Lancet 366 9491 1059 1062 16182882
- Allison DB Mentore JL 1999 Antipsychotic-induced weight gain: a comprehensive research synthesis The American journal of psychiatry 156 11 1686 1696 10553730
- Brar JS Ganguli R 2005 Effects of behavioral therapy on weight loss in overweight and obese patients with schizophrenia or schizoaffective disorder J Clin Psychiatry 66 2 205 212 15705006
- Bushe CJ Taylor M 2010 Mortality in schizophrenia: a measurable clinical endpoint Journal of psychopharmacology 24 4 Suppl 17 25 20923917 PMC2951589
- Citrome L 2011 Iloperidone, asenapine, and lurasidone: a brief overview of 3 new second-generation antipsychotics Postgraduate medicine 123 2 153 162 21474903
- El-Sayeh HG Morganti C 2006 Aripiprazole for schizophrenia Cochrane database of systematic reviews 2 CD004578 PMC11361475 16625607
- Ganguli R 2007 Behavioral therapy for weight loss in patients with schizophrenia J Clin Psychiatry 68 Suppl 4 19 25 17539696
- Goff DC Sullivan LM 2005 A comparison of ten-year cardiac risk estimates in schizophrenia patients from the CATIE study and matched controls Schizophrenia research 80 1 45 53 16198088
- Hennekens CH Hennekens AR 2005 Schizophrenia and increased risks of cardiovascular disease American heart journal 150 6 1115 1121 16338246
- Holt RI Pendlebury J 2010 Intentional weight loss in overweight and obese patients with severe mental illness: 8-year experience of a behavioral treatment program The Journal of clinical psychiatry 71 6 800 805 20361917
- Kim SH Ivanova O 2007 Metabolic impact of switching antipsychotic therapy to aripiprazole after weight gain: a pilot study Journal of clinical psychopharmacology 27 4 365 368 17632220
- Leucht S Komossa K 2009 A meta-analysis of head-to-head comparisons of second-generation antipsychotics in the treatment of schizophrenia Am J Psychiatry 166 2 152 163 19015230
- McEvoy JP Meyer JM 2005 Prevalence of the metabolic syndrome in patients with schizophrenia: baseline results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III Schizophr Res 80 1 19 32 16137860
- Nasrallah HA Meyer JM 2006 Low rates of treatment for hypertension, dyslipidemia and diabetes in schizophrenia: data from the CATIE schizophrenia trial sample at baseline Schizophr Res 86 1–3 15 22 16884895
- Newcomer JW 2005 Second-generation (atypical) antipsychotics and metabolic effects: a comprehensive literature review CNS Drugs 19 Suppl 1 1 93 15998156
- Reaven GM 2005 The metabolic syndrome: requiescat in pace Clinical chemistry 51 6 931 938 15746300
- Stroup TS McEvoy JP 2011 A Randomized Trial Examining the Effectiveness of Switching From Olanzapine, Quetiapine, or Risperidone to Aripiprazole to Reduce Metabolic Risk: Comparison of Antipsychotics for Metabolic Problems (CAMP) The American journal of psychiatry 168 9 947 956 21768610 PMC3773729
- Taylor F Ward K 2011 Statins for the primary prevention of cardiovascular disease Cochrane database of systematic reviews 1 CD004816 PMC4164175 21249663
- Wilson PW D’Agostino RB 1998 Prediction of coronary heart disease using risk factor categories Circulation 97 18 1837 1847 9603539
Cited by
Sorted by citations
Correll, C. U., Detraux, J., De Lepeleire, J., & De Hert, M. (2015) · World Psychiatry · doi:10.1002/wps.20204 · Cited by 820 · see citing works
Reversibility of Antipsychotic-Induced Weight Gain: A Systematic Review and Meta-Analysis
Speyer, H., Westergaard, C., Albert, N., Karlsen, M., Stürup, A. E., Nordentoft, M., & Krogh, J. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.577919 · Cited by 44 · see citing works
- Authors
- Stroup, T. S., Byerly, M. J., Nasrallah, H. A., Ray, N., Khan, A. Y., Lamberti, J. S., Glick, I. D., Steinbook, R. M., McEvoy, J. P., & Hamer, R. M.
- Affiliations
- New York State Psychiatric Institute (US)
- The University of Texas Southwestern Medical Center (US)
- University of Cincinnati (US)
- University of North Carolina at Chapel Hill (US)
- University of Rochester (US)
- Stanford University (US)
- University of Miami (US)
- Duke Medical Center (US)
- Corresponding author
- Stroup, T. Scott
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2013-05
- Volume
- 146
- Issue
- 1-3
- Pages
- 190-195
- ISSN
- 0920-9964 (ISSN-L)
- PMC
- PMC3622801
- OpenAlex
- W2063649818
- Cited by
- 39
- References
- 3
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 8 · 2020: 1 · 2019: 1 · 2018: 4 · 2017: 1 · 2016: 3 · 2015: 5 · 2014: 4
- FWCI
- 2.60
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Funders
- National Institute of Mental Health (N01 MH900001)
- Foundation for the National Institutes of Health
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- aripiprazole, olanzapine
- MeSH terms
- Aripiprazole, Quetiapine Fumarate, Olanzapine, Adult, Benzodiazepines, Coronary Artery Disease, Dibenzothiazepines, Female, Humans, Longitudinal Studies, Male, Middle Aged, Piperazines, Antipsychotic Agents, Multicenter Studies as Topic, Quinolones, Odds Ratio, Risperidone, Metabolic Syndrome, Drug Substitution
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
